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Plantar warts

Dear friends,

Do you have a magic solution for treatment of plantar warts? I have a petient which i try to manage for one year.. we did electrocauterisation, cryotherapy and aldara.. but they are still becoming larger and even new lesions are appearing..
What else can i do?
Thanks for your contribution!
BW

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Permalink Reply by Mark Horowitz on April 21, 2010 at 3:48pm

i have used bleo with great success. if you want to go with a less invasive option, either mediplast (40% sal acid plaster) under 24 hour occlusion, with frequent paring of the lesion, or Lazer formaldehyde, which is 10% formaldehyde soln.

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Permalink Reply by Emek Kocatürk on April 22, 2010 at 8:05am

Thanks a lot for your reply. How do you use bleomycin?

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Permalink Reply by Mark Horowitz on April 22, 2010 at 10:46am

I mix bleo 1cc per unit of bleo. (if bleo comes in a 15 u vial, i add 15 cc)
i inject into the body of the wart using a 1cc lure lock syringe with a 30g needle. i usually only inject about 0.1cc.
you must tell the pt that a hemorrhagic bulle may develop and there may be some discomfort. i discourage any debridment during the healing phase.
sometime a second treatment may be nec. depending on how large the wart is.

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Permalink Reply by Emek Kocatürk on April 26, 2010 at 5:11am

OK, that is very useful. Thank you very much for your reply.

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Permalink Reply by Dr. Sapna Chotai on January 23, 2011 at 7:36am

Hi,

I would like to suggest the use of topical 5 fluorouracil. I came across similar case but it was in nails n not on the planter surface. Hope u will use it n please share about the results. Thanks.

Your's sincerely,

Dr.Sapna Chotai.

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Permalink Reply by Mark Horowitz on January 23, 2011 at 8:50pm

I have also had good sucess with topical 5 FU. However, it is also usually periungal lesions. I used 5% under occulsion. I have never had great sucess with it on the plantar surface.

I have also used cadida Antigen. It only works 20-30% of the time, but when it does work, it is amazing.

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Permalink Reply by Emek Kocatürk on January 25, 2011 at 11:48am

Thank you very much for your replies! I will try these in future patients. The funny thing is the patient left the city and she later called me and said that she found the magic solution: sertraline. She does not have any plantar warts now!

Best wishes to you all, thank you very much for your help!

I would be very happy if you would share ND-YAG laser experiences for warts, if you have any.

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Permalink Reply by Dr. Sapna Chotai on May 6, 2011 at 8:26pm

hi.

have u tried topical 5-Fluorouracil or imiquimod...they do wonders..let me know how they worked in your patient. Take care.

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Permalink Reply by Susan Huang on July 11, 2011 at 10:27pm

In one of my clinics, we usually recommend the salicylic acid plaster first (Mediplast) first. We've used diphenylcyclopropenone (DCB) (topical sensitizing agent) and candida Ag injections with good results as well.

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Permalink Reply by viral thakkar on July 18, 2011 at 9:02am

autoimplantation is also a good option for difficult warts.

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Permalink Reply by abdul mubarak seenikatty on July 25, 2011 at 11:34pm

Thanks for all the remedies +tips.,please assure the pts.immune status esp. inspite of std.protocol if response is poor.,when you ablate a warty lesion by whatever method., you create a chance for the Viral virions to to be taken up by the immune stimulating cells like Macropages and the pts. system is primed to produce auto abs.and this can assist to self cure the pts. lesions at all sites.involved.

dr.seeni.