TO COMPARE EFFICACY BETWEEN CRYOTHERAPY AND MITOMYCIN MICRONEEDLING FOR THE TREATMENT OF PLANTAR WARTS

Authors

  • Faheema Afsar Khan CPSP
  • Majid Hussain National University of Medical Sciences, Rawalpindi-Pakistan
  • Bushra muzaffar Khan National University of Medical Sciences, Rawalpindi-Pakistan
  • Saima afsar CPSP
  • Mairah shafique National University of Medical Sciences, Rawalpindi-Pakistan
  • Sami ul Haq CPSP
  • Nadia Akbar CPSP
  • Adeel Siddique National University of Medical Sciences, Rawalpindi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-01-10932

Abstract

Background: Cryotherapy is a common destructive treatment modality for treating plantar warts that results in blistering and scarring. Mitomycin an antitumor drug with antiviral property is a safe, better and a promising option for treating plantar warts. Objective was to compare efficacy of cryotherapy and mitomycin microneedling in the management of plantar warts. It was a randomized controlled trial conducted at the Skin Department CMH Abbottabad from 1st May to 31st December 2021. Methods: The study included 60 patients with plantar warts. Each group with 30 patients. Random tables were used to determine the distribution of patients within each group. Group A received mitomycin microneedling (1u/ml) repeated every 3 weeks. Group B was prescribed liquid nitrogen cryotherapy. The freeze-thaw cycle was 20 secs and repeated every 2 weeks. Both groups were treated for 4 months duration were. For analysis of data, SPSS version 21.0 was used. Efficacy was compared by the application of Chi-square test between the two groups. p<0.05 was considered statistically significant. Results: Mitomycin microneedling completely cured 76.7% of patients, while cryotherapy was effective for only 56.7%. Complete remission was observed after two to three sessions of mitomycin microneedling while average of 4 sessions of cryotherapy were required for complete remission. In general, microneedling with mitomycin had better tolerance, pain being the commonest adverse effect. Conclusion: Plantar warts can be effectively treated with mitomycin microneedling. Treatment of plantar warts with this method is more effective, requires fewer sessions, and may take less time to complete.

Author Biographies

Faheema Afsar Khan, CPSP

 

Majid Hussain, National University of Medical Sciences, Rawalpindi-Pakistan

 

Bushra muzaffar Khan, National University of Medical Sciences, Rawalpindi-Pakistan

 

Saima afsar, CPSP

 

Mairah shafique, National University of Medical Sciences, Rawalpindi-Pakistan

 

Sami ul Haq, CPSP

 

Nadia Akbar, CPSP

 

Adeel Siddique, National University of Medical Sciences, Rawalpindi-Pakistan

 

References

Witchey DJ, Witchey NB, Roth-Kauffman MM, Kauffman MK. Plantar warts: epidemiology, pathophysiology, and clinical management. J Osteopath Med 2018;118(2):92–105.

de Planell‐Mas E, Martínez‐Garriga B, Zalacain AJ, Vinuesa T, Viñas M. Human papillomaviruses genotyping in plantar warts. J Med Virol 2017;89(5):902–7.

Garcia‐Oreja S, Álvaro‐Afonso FJ, García‐Álvarez Y, García‐Morales E, Sanz‐Corbalán I, Lazaro Martinez JL. Topical treatment for plantar warts: A systematic review. Dermatol Ther 2021;34(1):e14621.

Abeck D, Tetsch L, Lüftl M, Biedermann T. Extragenital cutaneous warts–clinical presentation, diagnosis and treatment. J Dtsch Dermatol Ges 2019;17(6):613–34.

Winterton S, Daly S. What is the best treatment for plantar warts? Evid-Based Pract 2018;21(6):12.

Ringin SA. The effectiveness of cutaneous wart resolution with current treatment modalities. J Cutan Aesthetic Surg 2020;13(1):24.

Muhaidat JM, Al-Qarqaz FA, Alshiyab DM, Alkofahi HS, Khader Y, Ababneh MY. Comparison of the Efficacy and Safety of Two Cryotherapy Protocols in the Treatment of Common Viral Warts: A Prospective Observational Study. Dermatol Res Pract 2020;2020:2309309.

Thappa DM, Chiramel MJ. Evolving role of immunotherapy in the treatment of refractory warts. Indian Dermatol Online J 2016;7(5):364.

Chiu TM, Hsu PC, Khan MY, Lin CA, Lee CH, Hsu TC, et al. A Perspective on Imiquimod Microneedles for Treating Warts. Pharmaceutics 2021;13(5):607.

Ryu HR, Jeong HR, Seon-Woo HS, Kim JS, Lee SK, Kim HJ, et al. Efficacy of a bleomycin microneedle patch for the treatment of warts. Drug Deliv Transl Res 2018;8(1):273–80.

Songsantiphap C, Asawanonda P. Topical 15% Zinc Oxide Ointment Significantly Reduces the Size of Common Warts After Four Weeks: A Randomized, Triple-blinded, Placebo-controlled Trial. J Clin Aesthetic Dermatol 2019;12(9):26.

Fathy G, Sharara MA, Khafagy AH. Intralesional vitamin D3 versus Candida antigen immunotherapy in the treatment of multiple recalcitrant plantar warts: A comparative case–control study. Dermatol Ther 2019;32(5):e12997.

Mohta A, Kushwaha RK, Agrawal A, Sharma MK, Gautam U, Jain SK. Evaluation of the efficacy of intralesional measles, mumps, and rubella vaccine with intralesional Vitamin D3 as immunotherapies in the treatment of recalcitrant cutaneous warts in adult-A randomized placebo-controlled study. Indian Dermatol Online J 2021;12(6):879.

Abdel Meguid AM, Abdel Motaleb AA, Abdel Sadek AM. Cryotherapy vs trichloroacetic acid 90% in treatment of common warts. J Cosmet Dermatol 2019;18(2):608–13.

Karrabi M, Kheirkhah M, Shahrestanaki E, Thomas S, Sahebkar M. Comparison of 40% trichloroacetic acid and cryotherapy for the treatment of plantar warts: A single‐blind, randomized clinical trial. Dermatol Ther 2020;33(4):e13559. Ref no 15&22 are same

Samy N, Fadel M, Abdelfadeel D, Al-Daraji M. Topical Indocyanine Green Nanosystem for Photodynamic Therapy of Cutaneous Warts. Syst Rev Pharm 2020;11(11):571–8.

Huang K, Xie Y, Li M, Liu D, Su J, Li F, et al. A comparative study: superficial shaving combined with photodynamic therapy versus cryotherapy in the treatment of recalcitrant plantar warts. Lasers Surg Med 2020;52(8):747–52.

Albalat W, Attwa E, Ebrahim HM. Intralesional cryotherapy versus cryotherapy spray for the treatment of recalcitrant plantar warts: a prospective, randomized study. J Dermatol Treat 2022;33(2):857–63.

Yousaf F, Raza N, Ahmed N, Sadiq S, Anwar A. Comparison of intralesional vitamin d3 versus cryotherapy for management of plantar warts. Pak Armed Forces Med J 2019;69(6):1304–8.

Kaul S, Jakhar D, Kaur I. Gray-white discoloration of wart surface: An endpoint for multipuncture-assisted delivery of bleomycin. J Am Acad Dermatol 2021;84(5):e227–8.

Kamal T, Ahmad F, Iftikhar U. Efficacy and safety of intralesional 5-fluorouracil in treatment of warts. J Pak Assoc Dermatol 2018;28(3):337–9.

Ma'luf RN. Treatment of recurrent eyelid margin verruca vulgaris with mitomycin C. Ophthal Plast Reconstr Surg 2010;26(3):214–5.

Soni P, Khandelwal K, Aara N, Ghiya BC, Mehta RD, Bumb RA. Efficacy of Intralesional Bleomycin in Palmo-plantar and Periungual Warts. J Cutan Aesthet Surg 2011;4(3):188–91.

Cockayne S, Hewitt C, Hicks K, Jayakody S, Kang'ombe AR, Stamuli E, et al. Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial. BMJ 2011;342:d3271.

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Published

2023-01-16

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