Efficacy of 595 nm Pulsed Dye Laser in Treatment of Recalcitrant Plantar Warts
Amira Mahmoud Abd El Halim;
Abstract
Warts are a common dermatological disease caused by multiple strains of the HPV. Multiple modalities are available for the treatment of warts with variable effectiveness. These modalities are frequently painful and may cause scarring. Some of these treatments include destructive methods as cryotherapy, chemical cautery, surgical excision and laser ablation.
Lasers have developed markedly over the previous decade, making them a valuable option for treatment.
Pulsed Dye Laser has a 595 nm wavelength in the yellow light spectrum, which is absorbed by hemoglobin and oxyhemoglobin leading not only to selective microvascular photothermolysis to induce thermal damage and localized tissue necrosis but also prevents replication of virus in cells infected by HPV probably due to immunomodulating properties of PDL which contribute in wart healing.
The PDL has been proved to be effective and safe method in the treatment of different types of warts. Side effects reported are limited and infrequent. However few researches were reported in the treatment of recalcitrant warts by PDL.
Recalcitrant verrucae are warts which fail to respond to conventional treatment. These lesions are often frustrating for the patient and pose a therapeutic problem.
In the current study, 51 patients with recalcitrant plantar warts were treated with PDL (595 nm). They were 23 males and 21 females with age ranging from 16 – 48 years (mean age 28.2 years). Seven cases were missed while 44 patients completed this study.
Recalcitrant Plantar warts were subjected to PDL treatment by 3 overlapping pulses for each lesion per session and sessions were done every 2 weeks until satisfactory results were obtained with maximum 6 sessions. The clinical evaluation of the treated cases was assessed according to response of treatment divided into 4 groups: complete response group with complete resolution (100%), partial response group 50%–90 % resolution, poor response group with improvement < 50 % and no response group.
Complete resolution was achieved in 10 patients (22.7%) out of the 44 patients who completed the study. The average number of sessions needed for complete clearance was 4 sessions.
There was no significant difference between males and females responses. A significant relation was found between DM and treatment outcome where all diabetic patients had poor response.
Lasers have developed markedly over the previous decade, making them a valuable option for treatment.
Pulsed Dye Laser has a 595 nm wavelength in the yellow light spectrum, which is absorbed by hemoglobin and oxyhemoglobin leading not only to selective microvascular photothermolysis to induce thermal damage and localized tissue necrosis but also prevents replication of virus in cells infected by HPV probably due to immunomodulating properties of PDL which contribute in wart healing.
The PDL has been proved to be effective and safe method in the treatment of different types of warts. Side effects reported are limited and infrequent. However few researches were reported in the treatment of recalcitrant warts by PDL.
Recalcitrant verrucae are warts which fail to respond to conventional treatment. These lesions are often frustrating for the patient and pose a therapeutic problem.
In the current study, 51 patients with recalcitrant plantar warts were treated with PDL (595 nm). They were 23 males and 21 females with age ranging from 16 – 48 years (mean age 28.2 years). Seven cases were missed while 44 patients completed this study.
Recalcitrant Plantar warts were subjected to PDL treatment by 3 overlapping pulses for each lesion per session and sessions were done every 2 weeks until satisfactory results were obtained with maximum 6 sessions. The clinical evaluation of the treated cases was assessed according to response of treatment divided into 4 groups: complete response group with complete resolution (100%), partial response group 50%–90 % resolution, poor response group with improvement < 50 % and no response group.
Complete resolution was achieved in 10 patients (22.7%) out of the 44 patients who completed the study. The average number of sessions needed for complete clearance was 4 sessions.
There was no significant difference between males and females responses. A significant relation was found between DM and treatment outcome where all diabetic patients had poor response.
Other data
| Title | Efficacy of 595 nm Pulsed Dye Laser in Treatment of Recalcitrant Plantar Warts | Other Titles | دراسة تأثير الليزر الصبغى النبضى ٥٩٥ نانو ميتر فى علاج الثآليل الاخمصية المتمردة | Authors | Amira Mahmoud Abd El Halim | Issue Date | 2013 |
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