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Recent studies that examined the treatment efficacy of Candida antigen injection for both non-genital and genital warts yield inconsistent results. To address this, a systematic review and meta-analysis was conducted, comparing the treatment response between Candida antigen injection therapy and other intralesional immunotherapies across all types of warts. PubMed, Cochrane Library, and Embase were searched for relevant randomized controlled trials (RCTs) from inception to 16 September 2023, and 24 eligible RCTs were identified. A protocol was developed using the PRISM A-P checklist. In terms of complete clearance, intralesional Candida injection therapy demonstrated a significant improvement compared with saline (risk ratio [RR] 5.39; 95% confidence interval [CI] 3.49–8.33; I2=0%). However, no statistically significant differences were observed when compared with other therapies such as mumps–measles–rubella vaccines, purified protein derivative, vitamin D3, bivalent human papillomavirus vaccine, and zinc sulphate. Adverse effects associated with intralesional Candida therapy were generally reported as mild and manageable. In conclusion, intralesional Candida injection therapy for cutaneous warts may exhibit a superior complete and distant response rate. Nevertheless, owing to a limited sample size and other limitations, future research should aim for larger studies to provide more conclusive evidence.

Background: Common cutaneous non-genital viral warts are a common skin infection with significant morbidity in the pediatric population. Although various therapeutics are available, many of them necessitate recurrent patient visits and may be associated with significant irritation and pain. Verrulyse Methionine® (VM), a nutritional supplement, was previously suggested as a non-invasive treatment option for the disease. Objective: To assess the response to oral VM supplement as a monotherapy in a cohort of children and adolescents with multiple, non-genital viral warts after failing previous treatments. Methods: We reviewed medical records of pediatric patients (<18 y/o) with viral warts treated with VM between 2010 and 2021. Results: Among 25 patients with multiple verrucae vulgaris lesions who failed previous treatments, 14 (56%) had complete or almost-complete response to VM within 4 months, after an average of 18 months of active disease prior to VM treatment initiation. None of the 4 patients with verruca plana had response to VM treatment. Favourable cosmetic results were found in responders, and no adverse events were recorded. Conclusion: Response rates in our cohort are comparable to those reported in the literature for destructive local therapeutics for viral warts. Thus, our data suggest that VM may be considered for children with multiple verrucae vulgaris, providing a painless and non-invasive therapeutic option for this common disease. [ABSTRACT FROM AUTHOR]

Objective: Multiple palmoplantar warts, caused by human papillomavirus (HPV) infection, were investigated for clinical efficacy using cantharidin, retinoic acid cream, and salicylic acid cream. Methods: A total of 110 patients with multiple palmoplantar warts were enrolled. The experimental group (54 cases) received a 1:1:1 combination (CRS) of 0.25% cantharidin, 0.1% retinoic acid cream, and 5% salicylic acid, applied with pressurized encapsulation for 8 h every night, three times per week. The control group (56 cases) underwent conventional liquid nitrogen freezing. Monthly follow‐ups assessed cure rate, effective rate, dermatological life quality index (DLQI), visual analog scale (VAS), and cost, with evaluations conducted after 3 months. Results: The treatment group exhibited a cure rate of 85.19% and a total effective rate of 96.30%, surpassing the control group with rates of 39.29% and 51.79%, respectively (p < 0.05). The treatment group's DLQI score (1.84 ± 1.06) was significantly lower than the control group's score (6.04 ± 1.78) (p = 0.0005). Additionally, the treatment group's VAS score (1.84 ± 1.06) was notably lower than the control group's score (8.56 ± 1.07) (p < 0.0001). The treatment group's total cost (43.20 ± 2.85) was markedly lower than the control group's cost (206.38 ± 90.81), with a statistically significant difference (p < 0.0001). Conclusion: The combination of cantharidin, retinoic acid cream, and salicylic acid with local encapsulation is a safe, effective, economical, and convenient treatment method for multiple palmoplantar warts, exhibiting few side effects and showing promise. [ABSTRACT FROM AUTHOR]

Introduction: Recalcirant warts are resistant to conventional therapeutic option with high recurrence rate. In recent year, treatment of warts with different immunotherapeutic agent has shown good results, as it regulate epidermal cell proliferation and are involved in the formation of anti microbial peptides. Hence, this study was undertaken to evaluate the efficacy of immunotherapy with intralesional vitamin D in wart. Methods: A descriptive cross-sectional study was conducted from 1 January 2021 to 2 February 2023 at Kathmandu Medical College after approval from the Institutional Review Committee (Reference number: 0110202002). Ninety - two patients with recalcitrant wart of varying sizes and duration were included in the study. Injection vitamin D ( 600000 IU, 15mg/ ml) was injected about (0.2-0.5 ml) to the base of the wart. Maximum of five warts were injected per month, and was repeated after 4 weeks for 3 sessions. Results: Among 92 patient, complete response was seen in 70 patient (76.08%), partial response was seen in 17 patients ( 18.47%) and 5 patient(5.43%)showed no response. Mild pain as observed at the time of injection. Signs of hypervitaminosis D was not observed. Conclusions: Intralesional administration of Vitamin D is an effective treatment option for reclacitrant warts and is, highly effective, cost-efficient, with minimal adverse effects, and can be perfomed in our clinical set up

Intralesional therapies are used for recalcitrant warts, but no Food and Drug Administration–approved treatment exists nor is there consensus regarding the most efficacious therapy. Therefore, this systematic review aims to summarize efficacy and adverse events reported in 62 randomized controlled trials (RCTs) of intralesional therapies for cutaneous warts. The most studied intralesional therapies included measles, mumps, rubella (MMR) vaccine (n = 24 studies), purified protein derivative (PPD) (n = 19 studies), vitamin D3 (n = 15 studies), and Candida antigen (n = 14 studies). Most studies included adult and pediatric patients or adults alone, with only 4 studies on pediatric patients alone. MMR vaccine was the most studied treatment (n = 853 patients). MMR had a complete response rate of 27–90%. The next most common treatment, PPD, had a complete response rate of 45–87%. Other treatments included Candida antigen and vitamin D3, with complete response rates of 25–84% and 40–96%, respectively. The most frequent side effects were injection-site reactions and flu-like symptoms. This systematic review represents a useful summary of intralesional therapy RCTs for clinician reference. This study also highlights the lack of large multi-institutional RCTs, despite many patients being treated for this widespread problem.

Human Papillomavirus (HPV) are non enveloped Deoxyribonucleic Acid (DNA) viruses, sized between 50-55 nm, that form two distinct groups to cause epithelial proliferation at cutaneous and mucosal surfaces, which are mostly benign. With more than 100 different HPV types, estimated 30-40 strains affect human genital tract. Of which, 16, 18, 31, 33, 35, 39, 45, 51, 52, and 5 are the oncogenic (high-risk) types associated with cervical, vulvar, vaginal, and anal cancers, and 6, 11, 40, 42, 43, 44, and 54 are non oncogenic (low-risk) types and are associated with genital warts. HPV 6 and 11 are more commonly associated with genital warts and are also responsible for approximately 90% of these lesions. Despite a series of modalities available to treat HPV, that range from topical to immunotherapeutic modalities to surgically destructive procedures, there is no promising, stand-alone modality which still is a cause of dilemma for Dermatologists while treating warts. The present article reviews all the treatment modalities commonly applied in practice and also the areas less explored by their level of evidences.

Human papillomavirus (HPV) is ubiquitously distributed in the population worldwide and its most frequent clinical presentation is cutaneous warts. Despite various treatment options currently available, many patients experience persistent and refractory disease. We sought to evaluate the clinical effectiveness and safety profile of intralesional HPV 9‐valent vaccine for the treatment of recalcitrant warts. A retrospective study was performed for all cases of cutaneous warts treated with intralesional 9‐valent HPV vaccine between January 2017 and March 2021. Epidemiologic, clinical, and treatment data, including safety and effectiveness scores, were reviewed. Our cohort was composed of 20 patients: 13 adults and seven children. Twelve patients (60%) displayed a complete response whereas 8 patients (40%) showed a partial response. Older age was associated with a better response to treatment, while a history of laser therapy was associated with a worse prognosis. Adverse events were local, transient, and negligible. No systemic adverse effects were reported. Intralesional 9‐valent HPV vaccine may be considered for the treatment of recalcitrant cutaneous warts. Controlled studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Plantar warts (verrucae plantaris) are a common source of pain for patients and are often refractory to treatment. Previous work has shown a high clearance rate of verrucae using a surface‐based microwave device (Swift®). Aims: To assess the efficacy, defined as the complete visible clearance of warts, in patients with verrucae plantaris receiving microwave treatment. Patients: We undertook a retrospective review and identified records of 85 patients who underwent a course of microwave treatment at a single US‐based podiatry centre. Efficacy was analyzed on the basis on intention‐to‐treat. Results: In patients who received ≥1 session there was a complete clearance rate of 60.0% (51/85) (intention‐to‐treat; 59 patients completed treatment, 26 lost to follow‐up) and 86.4% (51/59) per treatment completion; no significant differences in clearance rates of children and adults were observed (61.0% [25/41] vs. 59.1% [26/44]). There were 31 patients who received three sessions of microwave therapy with a clearance rate of 71.0% (22/31) as per intention‐to‐treat (27 patients completed treatment, 4 lost to follow‐up). An average of 2.3 sessions (SD: 1.1; range: 1–6) was required for the complete clearance of plantar warts. Complete clearance was also observed in some patients with recalcitrant warts following additional treatment sessions (42.9% [3/7]). A significant reduction in wart related pain was reported for all patients undergoing treatment. Some patients continued to report a reduced amount of pain post‐therapy compared with pretherapy. Conclusions: Microwave treatment of verrucae plantaris appears to be a safe and effective procedure. [ABSTRACT FROM AUTHOR]

This article discusses the challenges posed by periungual verruca, a viral infection that affects the area around the nails. Traditional treatments for this condition often have issues with recurrence and potential damage to the nail. The author proposes the use of bleomycin tattooing as an innovative approach to treating periungual verruca. This method involves creating micro-punctures using a tattoo needle and immersing the area in a bleomycin solution. The technique has shown remarkable efficacy, with resolution of the lesion observed after a single session. Bleomycin tattooing is presented as an economical and effective option for treating periungual verruca, addressing the limitations of traditional treatments. [Extracted from the article]

Human Papillomavirus (HPV) are non enveloped Deoxyribonucleic Acid (DNA) viruses, sized between 50-55 nm, that form two distinct groups to cause epithelial proliferation at cutaneous and mucosal surfaces, which are mostly benign. With more than 100 different HPV types, estimated 30-40 strains affect human genital tract. Of which, 16, 18, 31, 33, 35, 39, 45, 51, 52, and 5 are the oncogenic (high-risk) types associated with cervical, vulvar, vaginal, and anal cancers, and 6, 11, 40, 42, 43, 44, and 54 are non oncogenic (low-risk) types and are associated with genital warts. HPV 6 and 11 are more commonly associated with genital warts and are also responsible for approximately 90% of these lesions. Despite a series of modalities available to treat HPV, that range from topical to immunotherapeutic modalities to surgically destructive procedures, there is no promising, stand-alone modality which still is a cause of dilemma for Dermatologists while treating warts. The present article reviews all the treatment modalities commonly applied in practice and also the areas less explored by their level of evidences. [ABSTRACT FROM AUTHOR]

Background and Design: Internalized stigma is the acceptance of negative stereotypes about the disease created by society and withdrawing of oneself from society with emotions such as worthlessness and shame. This study aimed to investigate the internalized stigma status of patients with verruca. Materials and Methods: A total of 58 patients with verruca were included in this study. The sociodemographic and clinical characteristics of these patients were recorded. The Internalized Stigma Scale (ISS) was used. In addition, patients answered the 12-Item General Health Questionnaire-12 (GHQ-12) and the Perceived Health Status question. Results: The mean ISS total score was 52.17+-14.73. Cronbach's alpha coefficient for the whole scale for patients with verruca was 0.92. Among the five ISS subscales in patients with verruca, the lowest internal consistency was found in the 'stigma resistance' subscale (Cronbach's alpha coefficient: 0.572), and the highest internal consistency was in the 'social withdrawal' subscale (Cronbach's alpha coefficient: 0.890). A significant correlation was found between the GHQ-12 and ISS total or ISS subscales, except for the 'stigma resistance' subscale (p

Background: In 2007, skin cancers were third most common malignancies in Indonesia. However, profile of cutaneous tumors in our institution has not been studied. Purpose: To evaluate profile of cutaneous tumors in Dermatology and Venerology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: This is a descriptive retrospective study. Inclusion criteria was new cutaneous tumor patients. Exclusion criteria was incomplete data. Medical record and photograph database from 2019-2020 were assessed for demography, clinical features, histopathological examination and final diagnosis. Results: There were 379 (5,5%) cutaneous tumors among 6896 new patients at Dermatology and Venereology Outpatient Clinic. Overall, there were more female patients (53.7%) and age group of 0-45 years old (70.4%). Cutaneous tumors more commonly presented as papular (50.4%), multiple (56.5%), nonpigmented (58.3%), asymptomatic lesions (62.5%), with time from onset 0-24 months (66.2%) and location on head and face (61.2%). Benign cutaneous tumors showed similar findings. Malignant cutaneous tumors showed differences including predominantly male sex, age above 45 years old, nodular, solitary, pigmented and easily bleeding lesions. Malignant tumors were less common (6.9%). Most common malignant tumor was BCC. Most common benign and overall cutaneous tumor was seborrheic keratosis. Conclusion: Cutaneous tumors presented across gender and ages, showing heterogenous clinical manifestations. Malignant and benign cutaneous tumors showed similarity on time from onset and location of lesions. However, differences were seen in demographic profiles and majority of clinical features. BCC was the most common malignant cutaneous tumors, while seborrheic keratosis was the most common benign and overall cutaneous tumors.

Introduction: Warts are benign lesions caused by human papilloma virus. Various types of cutaneous warts include verruca vulgaris, genital warts, and palmoplantar warts. Various therapeutic modalities are available for warts with varying response. These include destructive therapies, cytotoxic agents (Bleomycin), and immunotherapy (measles, mumps, and rubella [MMR], candida antigen, etc.). We have analyzed the efficacy of intralesional MMR immunotherapy in patients with different kinds of cutaneous warts. Aim: The purpose of this study was to retrospectively analyze the effectiveness and safety of MMR immunotherapy in the treatment of different kinds of cutaneous warts. Materials and Methods: We included all the patients with cutaneous warts receiving MMR vaccine between March 2014 and March 2022. Demographic data were recorded. MMR vaccine was given for four doses at 3 weeks interval or till there was complete clearance, whichever was earlier. Clearance and reduction of wart sizes and potential side effects were recorded. Results: A total of 184 patients were enrolled, and 45% patients were women. Predominant age group of patients was 21--40 years. Most common types of warts observed was palmoplantar warts. Complete resolution was seen in 66% patients and partial response in 22% patients. Palmo-plantar and warts on extremities responded completely to immunotherapy, whereas 43% of genital warts had no improvement. Pain at injection site was observed in all patients, and 32% patients had flu-like symptoms. Conclusions: Immunotherapy with MMR vaccine shows a promising response in the treatment of palmo-plantar warts and warts on extremities, without any serious adverse effect, whereas the genital warts and verruca plana respond variably to immunotherapy. [ABSTRACT FROM AUTHOR]

Background: Verruca (non genital warts) is a quite common public health problem caused by viral infection of low risk Human Papilloma Virus (HPV) types, risking patients of all backgrounds. There is still no ideal treatment for verruca with little knowledge regarding the effectiveness of the available therapies, which results in the lack of therapeutic standard for patients. Purpose: To evaluate the incidence, management, and effectiveness of verruca treatment. Methods: This was a descriptive, retrospective study with a cross-sectional design. All patients diagnosed with verruca in Tumor and Skin Surgery Division of the Dermatology and Venereology Outpatient Unit at Dr. Soetomo General Academic Hospital Surabaya between January 2016 and December 2020 were included in the study. Result: The results of this study obtained a total of 113 verruca patients, consisting of 61 (53.98%) male patients and 52 (46.01%) female patients, mostly aged 20-60 years old (45 patients [39.82%]). The upper extremity was the most common location where the lesion was found (39 patients [34.5%]). Electrosurgery was the most performed method (38 patients [33.6%]). Thirty-one patients who were treated and returned to the clinic at least once during the month were evaluated for the resolution of the lesion after undergoing therapy. Among 31 patients, resolution was reported in 35.5% of cases. Conclusion: Verruca is a common condition in general practice with many treatment options available yet often neglected. Knowing the available evidence for efficacy of those treatments is critical for dermatologist when considering treatment and educate patients.

Background: Multiple treatment options are available for verruca, however none is completely effective. Conventional modalities such as salicylic acid, cryotherapy have inconsistent treatment efficacies. Newer modalities such as immunotherapy, bleomycin and lasers have shown higher clearance rates of warts in recent studies. Immunotherapy is an innovative approach to treat warts which relies on the principle of enhancement of cell-mediated immunity. This study was done to evaluate the efficacy of immunotherapy with Tuberculin Purified Protein Derivative injection in palmoplantar verruca in our context. Materials and Methods: This is an open labelled, prospective interventional study. Patients with palmoplantar verruca enrolled in the study were injected with purified protein derivative intralesionally by an insulin syringe at a dose of 10 IU (0.1 mL) in the largest wart every 2 weeks until all lesions disappeared or for a maximum of six sessions. They were followed up for 3 months after final treatment session. Results: A total of 54 patients, 34 males and 20 females, were enrolled in the study. Commonest distribution of palmoplantar verruca was in plantar distribution (48.1%). Among them, 12 (22.2%) patients had periungual warts. Complete clearance of warts without any scarring was seen in 66.7% (36) patients with palmoplantar verruca at the end of 6th session whereas 33.3% (18) patients did not respond. Adverse effects noted were erythema, edema and pain at injection site. Conclusion: Intralesional injection of purified protein derivative is an effective and inexpensive treatment option for palmo-plantar verruca with good outcome.

Background: Human papillomavirus (HPV) is the causative agent of verruca and is contagious, recurrent, and recalcitrant due to defects in cell-mediated immunity. No single mode of treatment is completely effective. The most commonly used treatment options are destructive and lead to scarring. The emerging new modality of treatment is immunotherapy, which acts by enhancing cell-mediated immunity (CMI) against HPV to clear treated as well as remote warts. Objectives: The objective was to compare the efficacy of intralesional Measles, Mumps, and Rubella (MMR) vaccine and intralesional vitamin D3 in cutaneous warts. Materials and Methods: A randomized, hospital-based, single-blind study on forty patients divided into two groups (groups A and B), comprising twenty patients each, was conducted. In group A, intralesional MMR vaccine 0.5 mL was injected into the base of warts. In group B, intralesional vitamin D3 0.5 mL was injected into the base of warts after achieving local anesthesia. Sessions were performed in two-week intervals for a maximum number of five sessions. The patients were followed for sixteen weeks. Results: In group A (MMR vaccine), a complete response was seen in 75% (15/20) of the patients, a moderate response in 15% (3/20), a partial response in 5% (1/20), and no response in 5% (1/20). In group B (vitamin D3), a complete response was seen in 65% (13/20) of the patients, a moderate response in 15% (3/20), a partial response in 10% (2/20), and no response in 10% (2/20). No recurrence was noticed after follow-up in either of the two groups. Conclusion: Immunotherapy is an option that is easy, safe, cost-effective, and well-tolerated with minimal side effects. [ABSTRACT FROM AUTHOR]

Background and Design: Internalized stigma is the acceptance of negative stereotypes about the disease created by society and withdrawing of oneself from society with emotions such as worthlessness and shame. This study aimed to investigate the internalized stigma status of patients with verruca. Materials and Methods: A total of 58 patients with verruca were included in this study. The sociodemographic and clinical characteristics of these patients were recorded. The Internalized Stigma Scale (ISS) was used. In addition, patients answered the 12-Item General Health Questionnaire-12 (GHQ-12) and the Perceived Health Status question. Results: The mean ISS total score was 52.17±14.73. Cronbach's alpha coefficient for the whole scale for patients with verruca was 0.92. Among the five ISS subscales in patients with verruca, the lowest internal consistency was found in the "stigma resistance" subscale (Cronbach's alpha coefficient: 0.572), and the highest internal consistency was in the "social withdrawal" subscale (Cronbach's alpha coefficient: 0.890). A significant correlation was found between the GHQ-12 and ISS total or ISS subscales, except for the "stigma resistance" subscale (p<0.05). Conclusion: This study revealed that patients with verruca internalize the negative stereotypes of society about the disease. High levels of internalized stigma were related to poor GHQ scores. This may indicate that internalized stigma is associated with depression in patients with verruca. Thus, the psychosocial aspects of patients with verruca should be evaluated. [ABSTRACT FROM AUTHOR]

Introduction: Warts are benign hyperkeratotic viral infections poorly responsive to most treatment modalities. Commonly used destructive methods can cause the scarring of the digits. Intralesional agents are preferred in digital warts. Individual efficacy has been assessed, but previously intralesional bleomycin and immunomodulator measles, mumps, and rubella (MMR) vaccine have not been compared. Objectives: To assess the effectiveness and safety of intralesional bleomycin versus intralesional MMR vaccine in the treatment of digital warts. Materials and Methods: All consenting adults with =5 digital warts were randomly divided into two groups by chit method: group A got intralesional MMR vaccine and group B got intralesional bleomycin monthly for 3 months with follow-up at the fourth month. Clearance and reduction in wart sizes and side effects were noted. Results: Totally 45 patients completed the study, and with single injection, clearance in group B was significantly higher than in group A (P = 0.001, Chi-square test). Necrosis, eschar formation, and residual pain were seen in group B. Overall, there was no significant difference in clearance rates at three injections (P = 0.198, chi-square test). Conclusion: Intralesional MMR vaccine and intralesional bleomycin are both effective in treating digital verrucae. Faster clearance is seen with intralesional bleomycin, with more side effects such as necrosis, eschar, and pain, controlled with oral analgesics. [ABSTRACT FROM AUTHOR]

Introduction: Verrucae vulgaris, or common warts, is a common skin condition for which there is no US Food and Drug Administration-approved treatment. Compounded cantharidin has been used to treat warts for years but lacks a controlled formulation, consistent application schedule and methods, and robust safety and efficacy studies. VP-102 is a proprietary drug-device combination product containing a topical formulation of 0.7% (w/v) cantharidin in a single-use delivery device. This objective of the phase 2 study was to evaluate the efficacy, safety, tolerability, and optimal regimen of VP-102 in the treatment of common warts. Methods: In this open-label trial, participants aged ≥ 2 years with one to six common warts were administered VP-102 topically to treatable common warts once every 14 days (Cohort 1) or once every 21 days in conjunction with paring (Cohort 2), for up to four treatments. Participants were evaluated through to day 84 (Cohort 1) or day 147 (Cohort 2). The primary endpoint was the percentage of participants with complete clearance of all treatable common warts (baseline and new) at day 84. Secondary endpoints included percentage of participants achieving complete clearance of all treatable common warts at other visits. Safety assessments included treatment-emergent adverse events (TEAEs), including local skin reactions (LSRs). Results: A total of 21 and 35 participants were enrolled in Cohort 1 and Cohort 2, respectively. Complete clearance at day 84 was seen in 19.0% of participants in Cohort 1 and 51.4% of those in Cohort 2. The most common TEAEs were expected LSRs and included application site vesicles, pain, pruritus, erythema, and scab. Most LSRs were mild or moderate in severity. Conclusion: VP-102 showed efficacy in complete clearance of common warts from baseline to day 84, as well as at follow-up visits. Due to the higher percentage of patients exhibiting complete clearance in Cohort 2, the treatment regimen of Cohort 2 will be pursued in future studies. TEAEs were expected due to the pharmacodynamic action of cantharidin, a vesicant. Clinical Trials ID: NCT03487549 [ABSTRACT FROM AUTHOR]

Background/Objectives: In children, distinguishing anogenital warts (AGW) acquired innocently from those acquired by child sexual abuse (CSA) is challenging. High‐quality studies examining this relationship are sparse. Here, we sought to evaluate the association between AGW and sexual abuse in children 12 years of age and younger with respect to wart location, age, and gender. Methods: A systematic review of Ovid MEDLINE, Embase, and Web of Science was performed for studies published on or before 2/16/2018. Studies were eligible for inclusion if they contained at least 10 patients 12 years old and younger and reported the number of patients who were sexually abused. The principal summary measures were the odds ratios (OR) of reported CSA with respect to subject age, wart location, and gender. Results: Three hundred twenty‐seven studies were identified through record search. Twenty five were included in a summary synthesis (791 subjects); 10 were included in the final statistical analysis (199 subjects). In our overall review, 102 of 468 (21%) females and 36 of 204 (18%) males with AGW were abused or probably abused. Overlapping HPV types were found in abused and non‐abused subjects. Perianal location and gender were not significant predictors of abuse. Both age and genital wart location (penis, vulva) did significantly predict CSA (α =.05). The odds ratio for sexual abuse of children aged 3‐4 years was 7.45; 6.52 for ages 5‐8 years; and 6.93 for ages 9‐12 years compared to those 0‐2 years of age. Genital location was associated with an OR of CSA of 5.93. Conclusions: Our systematic review supports a significant association between AGW in a child greater than 2 years of age and odds of CSA. Genital wart location significantly predicts CSA as well. HPV typing is not a reliable method to ascertain CSA. Male family members and acquaintances were the most likely perpetrators of abuse. [ABSTRACT FROM AUTHOR]

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Background: Dermatophyte is a group of keratinophilic fungi that cause various skin lesions depending on the affected area. Dermatophytosis is usually diagnosed by clinical manifestation and confirmed by direct microscopy or fungal culture. There might be diagnostic difficulty with the presence of atypical dermatophytosis. Atypical dermatophytosis presents with clinical appearances ranging from eczematous, psoriasiform, pustular lesions, and others, that interferes with early diagnosis and disturbs patient’s life quality. Genital dermatophytosis is an uncommon presentation of cutaneous fungal infection; moreover, its manifestation without the involvement of the inguinal area, and simulating wart is a rare sign. In this study, we introduce a rare case of dermatophytosis with a wart-like appearance that was restricted to the skin of the genitalia. Case Presentation: A 24-years-old woman was referred to the academic dermatology clinic of Boo- Ali SINA Hospital in Sari, Iran, in November 2019 with a 9-month complaint of verrucous and pruritic plaque in the genital area that previously misdiagnosed as wart with no response to treatment. The dermatologist requested a review of the previous pathology documents for diagnosing dermatophytosis. The pathologists reexamined the relevant paraffin-embedded skin tissue block of the patient. By Periodic acid-Schiff staining, some fungal elements had been found in the horny layers of the epidermis, so dermatophytosis was confirmed. Based on this diagnosis, terbinafine was prescribed and the patient responded well to this treatment after four weeks. Conclusion: Although the occurrence of genital dermatophytosis with the verrucous appearance and without involvement of groin is a rare finding, it should be considered in the differential diagnosis. In each case suspected of genital dermatophytosis, direct examination or fungal culture for definite diagnosis and prevention of delay in the appropriate treatment is required. [ABSTRACT FROM AUTHOR]

Viral warts or verruca are very common skin infections in children. Although benign, lesions can be extensive, painful, bleed, or lead to cosmetic disfigurement. Although spontaneous resolution can occur, parents often bring their children for treatment, especially when they are symptomatic. Many publications have assessed the efficacy and safety of treatment of warts in adults. However, treatment in children can be challenging due to their immune responses and lower threshold for pain. We review the current literature on the methods, efficacy, and side effect profile of common treatment modalities for cutaneous viral warts in children. There is evidence that salicylic acid and cryotherapy are effective, and although cryotherapy is more effective, there is a higher risk of side effects such as pain and blistering. Combination treatment with salicylic acid and cryotherapy may reduce these side effects. Although there is limited data, other treatment options such as cantharidin, immunotherapy and other mechanical therapies, for example, carbon dioxide lasers, may also be considered, especially for recalcitrant lesions. [ABSTRACT FROM AUTHOR]

Background: Skin cancer is common, growing, challenging, and in need of progress in early‐stage treatment. 20 MHz high‐intensity focused ultrasound (HIFU) is new and applied to actinic keratosis (AK) and skin cancers for the first time. HIFU of lower frequency is already used in the treatment of internal cancers. Materials and Methods: Eight patients with 201 AK lesions, one patient with 7 basal cell carcinomas (reoccurrences after PDT), and one patient with 7 Kaposi sarcoma lesions (4 treated with radiotherapy in the past) were given 1‐3 HIFU treatments. Twenty megahertz HIFU was dosed as 150 ms at 0.6‐1.2 J/shot applied to target lesions. Probes with different target depths were available. The preferred shot energy and focal depth in AK were 0.9 J and 1.3 mm. A "Sandwich" strategy with HIFU applied in two depths were tried in cancers. The follow‐up period was 3‐6 months. Results: All AK cleared except 5, giving a cure rate of 97%. Post‐treatment lesion healed in 1‐2 weeks with no scar. VAS pain was from 1 to 8, and in any case less than experienced with previous PDT. In both basal cell carcinoma (BCC) and sarcoma, healing was confirmed by histological verification. Discussion/conclusion: 20 MHz HIFU was an effective and safe treatment of AK. This new treatment, applicable to any anatomical site, has promising advantages relative to PDT and has the potential to replace or supplement PDT in future. Case‐observations indicated that HIFU can be useful in skin cancers as well. [ABSTRACT FROM AUTHOR]

Background/aim: Verruca vulgaris is a benign disease characterized with papillomas on the skin and mucosa. The aim of this study was to investigate the serum levels of coenzyme Q10, MDA, and zinc as well as the lipid profile of verruca vulgaris patients and examine the relationship between these parameters and clinical manifestations of the disease. Materials and methods: The study included 49 verruca vulgaris patients (mean age: 32.01 ± 14.20 years; 22 males, 27 females) and 40 healthy volunteers (mean age: 31.63 ± 8.98 years; 21 males and 19 females). Coenzyme Q10 levels were assessed by using an enzymelinked immunosorbent assay. Serum MDA levels were measured spectrophotometrically. Zinc levels were measured using a Perkin Elmer AAnalyst 800 atomic absorption spectrometer with a deuterium background correction and additional standard techniques. Results: The coenzyme Q10 levels were found to be higher in the verruca vulgaris group compared to the healthy volunteers. However, this increase was not statistically significant (P = 0.195). Zinc levels were significantly lower in the verruca vulgaris group compared to the healthy volunteers (P = 0.002). In the patient group, MDA levels and HDL levels were significantly higher compared to the healthy volunteers (P = 0.023 and P = 0.004, respectively). Additionally, there was no statistically significant difference between the groups in the CoQ10/Total cholesterol ratio (P = 0.433). Conclusion: Reduced serum zinc levels and increase of oxidative stress in verruca vulgaris may be a factor responsible for development of verruca vulgaris. [ABSTRACT FROM AUTHOR]

Cutaneous warts are a common pediatric complaint with modest response to first‐line treatments. Warts are a manifestation of human papillomavirus (HPV) infection and are cleared by cell‐mediated immunity (CMI). Intralesional immunotherapy treatments have been studied as alternative therapies, particularly for recalcitrant or multiple warts, including Candida antigen, mumps antigen, the combined measles, mumps, and rubella (MMR) vaccine, tuberculin purified protein derivative (PPD), and bacille Calmette‐Guerin (BCG) vaccine. These treatments are thought to increase HPV recognition by stimulating CMI. In this review, we evaluate and compare the efficacy and adverse effects of intralesional immunotherapy in the treatment of pediatric warts. Articles met inclusion criteria if they specifically evaluated the effects of intralesional immunotherapy (candida, MMR, tuberculin PPD, or BCG) as treatment for cutaneous warts in a pediatric population, and if they quantified treatment effect in a reproducible manner. Twenty‐one studies met criteria. Many studies demonstrated complete clearance of injected common warts in pediatric patients with clearance rates ranging from 23.3% to 95.2%. Distant wart resolution was common. Intralesional immunotherapy is a promising treatment option for cutaneous warts in children. [ABSTRACT FROM AUTHOR]

Non-venereal warts are a frequent dermatological presentation with potential spontaneous regression in immunocompetent adults and children within 2 years. Evidence shows that conventional wart treatments are not a guaranteed treatment modality and can carry concerns regarding safety. The aim of this literature review was to identify the most effective treatments for wart resolution to guide clinical practice while identifying areas for further research. A systematic literature review was performed to determine the current treatment modalities for non-anogenital cutaneous warts in immunocompetent individuals and their effectiveness. Articles were categorized into one of eight groups depending on anatomical location, population age, or recalcitrant status with ranked levels of evidence. This literature review highlights a variety of treatments for non-venereal warts shown to be effective. In this instance where optimal evidence-based treatments are not available, clinical experience determines the most appropriate clinical practice. Further reproducible immunotherapy research on wart resolution is required to enable clear comparisons of these treatment modalities to conventional methods. Future clinical practice will require the human papillomavirus type to target the wart treatment accordingly; however, further research is required to determine these correlations. [ABSTRACT FROM AUTHOR]

Intralesional therapies are used for recalcitrant warts, but no Food and Drug Administration-approved treatment exists nor is there consensus regarding the most efficacious therapy. Therefore, this systematic review aims to summarize efficacy and adverse events reported in 62 randomized controlled trials (RCTs) of intralesional therapies for cutaneous warts. The most studied intralesional therapies included measles, mumps, rubella (MMR) vaccine (n = 24 studies), purified protein derivative (PPD) (n = 19 studies), vitamin D3 (n = 15 studies), and Candida antigen (n = 14 studies). Most studies included adult and pediatric patients or adults alone, with only 4 studies on pediatric patients alone. MMR vaccine was the most studied treatment (n = 853 patients). MMR had a complete response rate of 27-90%. The next most common treatment, PPD, had a complete response rate of 45-87%. Other treatments included Candida antigen and vitamin D3, with complete response rates of 25-84% and 40-96%, respectively. The most frequent side effects were injection-site reactions and flu-like symptoms. This systematic review represents a useful summary of intralesional therapy RCTs for clinician reference. This study also highlights the lack of large multi-institutional RCTs, despite many patients being treated for this widespread problem., (© 2024 The Authors.)

Copyright of Dermatoz is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Sensitivity about appearance is one of the sine qua non of adolescence and adolescents' self-esteem effecting their socialization processes. We explored if verruca vulgaris, a common visible infectious skin disease, affects social anxiety levels and self-esteem in adolescents compared to controls. Also, the difference in sociodemographic properties between two groups and the effect of clinical properties (the distribution and number of warts) on these parameters were investigated in the patient group. Materials and methods The study group consisted 98 adolescents (49 controls and 49 patients) without other medical/psychiatric diseases. The Sociodemographic form (SDF), the Çapa Social Phobia Scale for Children and Adolescents (ÇCASPS) and the Rosenberg Self-Esteem Scale (RSES) were completed by both groups. Results There was no difference in social anxiety levels and self-esteem between the two groups. Also, the control and patient groups were found matched. However, lower self-esteem was the only factor that increased the risk for social phobia in the patient group. Conclusion Verruca vulgaris distributed in hands and face in adolescents were not found to be related with higher social anxiety and lower self-esteem. However, clinicians should monitor psychiatric symptoms and especially lower self-esteem should be taken into account. [ABSTRACT FROM AUTHOR]

Verruca and molluscum contagiosum (MC) infections tend to involve some body parts that create aesthetic concern, e.g. facial, palmoplantar and genital area. Therefore, new searches are continuing especially in treatment resistant cases. In this article, it is aimed to review of literature data about the efficacy and safety of certain lasers and Intense Pulsed Laser (IPL) treatments frequently used in verruca and MC infections in recent years. The clinical studies, case series and reports which were published in the last 20 years have been examined. It has been determined that CO2 laser, Nd: YAG laser and PDL are effective treatment options in resistant verruca infections; however, further studies are needed to determine the efficacy of other lasers and IPL in treatment. PDL treatment can be an effective and reliable option in the treatment of MC, but it is not enough studies on this subject and more extensive studies are required. [ABSTRACT FROM AUTHOR]

Copyright of Kufa Journal for Nursing Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cutaneous and genital warts are common dermatological conditions caused by the human papilloma virus (HPV). Although it is a benign condition, it causes disfigurement, has a tendency to koebnerize, and can be transmitted to others. This makes adequate and timely treatment important. There are several conventional treatments available with variable response. Topical and systemic immunotherapy has now found a significant place in the treatment of warts because of its nondestructive action, ease of use, and promising results. Through this review, we would like to present a brief overview of the various immunotherapeutic agents used. These include more established agents such as imiquimod, Mycobacterium w vaccine, bacillus Calmette-Guérin vaccine, measles, mumps, and rubella vaccine, Candida antigen, trichophyton antigen, tuberculin, zinc, cimetidine, levamisole, HPV vaccine, and autoimplantation therapy. Other agents such as contact immunotherapy which is sparsely used now than before and newer agents such as Corynebacterium parvum, sinecatechins, echinacea, propolis, glycyrrizinic acid, and Vitamin D have also been discussed. The mechanism of action of these agents, along with their dosage, mode of administration, duration of use, expected outcomes and comparative efficacy, evidence for their use, and expected side effects, if any, are reviewed.

Background: Although many dermatologic surgeons are aware of the risks of surgical smoke, many do not use hazard reduction strategies.Objective: To identify the infectious, inhalational, chemical, and mutagenic risks of surgical smoke in dermatologic procedures and suggest evidence-based hazard reduction strategies.Methods: A review of articles indexed for MEDLINE on PubMed using the keywords surgical smoke, dermatology, surgical mask, respirator, smoke evacuator, and guidelines in 13 combinations was performed by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. The review included data from 45 articles from the dermatology, surgery, infectious disease, obstetrics, and cancer biology literature.Results: There are risks associated with surgical smoke, and although some dermatologists are aware of these risks, many are not using hazard reduction strategies such as smoke evacuators and surgical masks.Limitations: Most of the data regarding the hazards of surgical smoke and methods for smoke safety are derived from in vitro and in vivo studies in nonhumans, as well as from resources outside of the dermatology literature.Conclusion: Standardized guidelines for surgical smoke safety should be implemented in the dermatology community and residency curriculum. [ABSTRACT FROM AUTHOR]