Comparative efficacy of trichloroacetic acid combined with silver nitrate and cryotherapy in treating plantar warts study in Military Medical Specialty Center
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20250353Keywords:
Wart, Infection, Cryotherapy, Trichloroacetic acid, Silver nitrateAbstract
Background: Warts are benign growths that affect the skin and mucous membranes. Comparative studies evaluating the efficacy of trichloroacetic acid (TCA), silver nitrate, and cryotherapy for treating plantar warts reveals distinct advantages for each treatment modality. Objectives were to determine the comparative efficacy of TCA with silver nitrate and cryotherapy in treating planter warts.
Methods: It was a descriptive, descriptive analytical and cross-sectional hospital-based study conducted at MMSC. Data were analyzed by statistical package for social sciences (SPSS) version 26.
Results: Among the100 participants (82% male, 18% female). The age distribution showed that most participants were between 20-29 years (34%) and 30-39 years (33%). The duration of the disease was less than 3 months for (50%) participants, while (44%) had the disease for 3-6 months. Most participants were employed (89%), aged 20-39 years (67%), and had experienced plantar warts for less than six months (94%). Both groups achieved high rates of complete resolution (82% for TCA vs. 74% for cryotherapy), though the difference was not statistically significant. Recurrence was significantly lower in the TCA group (12%) compared to the cryotherapy group (38%). Treatment duration and side effects varied significantly between groups, with TCA showing shorter treatment durations and fewer side effects. Cryotherapy was associated with higher rates of moderate and severe side effects.
Conclusions: The study demonstrates that TCA with silver nitrate is more effective and has a better safety profile than cryotherapy for the treatment of plantar warts. These findings support the recommendation of trichloroacetic acid with silver nitrate as a first-line treatment option, particularly for patients with a high risk of recurrence or those who may be sensitive to the side effects of cryotherapy. Further research with larger sample sizes and longer follow-up periods are recommended to confirm these results and assess long-term outcomes.
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References
Krishna SK, Jethwa AS. Human papillomavirus infections in adults and children. Am J Epidemiol Infect Dis. 2013;1(2):11-9.
Bruggink SC, Gussekloo J, Berger MY, Zaaijer K, Assendelft WJ, de Waal MW, et al. Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trial. CMAJ. 2010;182(15):1624-30. DOI: https://doi.org/10.1503/cmaj.092194
Bruggink SC, Gussekloo J, de Koning MN, Feltkamp MC, Bavinck JN, Quint WG, et al. HPV type in plantar warts influences natural course and treatment response: secondary analysis of a randomised controlled trial. J Clin Virol. 2013;57(3):227-32. DOI: https://doi.org/10.1016/j.jcv.2013.02.021
Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield‐Jones SE, Hughes JR, et al. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Bri J Dermatol. 2014;171(4):696-712. DOI: https://doi.org/10.1111/bjd.13310
Bacelieri R, Johnson SM. Cutaneous warts: an evidence-based approach to therapy. Am Family Phys. 2005;72(4):647-52.
Gibbs S, Harvey I. Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews. 2006(3):CD001781. DOI: https://doi.org/10.1002/14651858.CD001781.pub2
Bruggink SC, Eekhof JA, Egberts PF, van Blijswijk SC, Assendelft WJ, Gussekloo J. Warts transmitted in families and schools: a prospective cohort. Pediatrics. 2013;131(5):928-34. DOI: https://doi.org/10.1542/peds.2012-2946
Sladden MJ, Johnston GA. Common skin infections in children. BMJ. 2004;329(7457):95-9. DOI: https://doi.org/10.1136/bmj.329.7457.95
Watkins P. Identifying and treating plantar warts. Nursing standard. 2006;20(42):50-4. DOI: https://doi.org/10.7748/ns2006.06.20.42.50.c6554
Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006;4(4):273-93. DOI: https://doi.org/10.3121/cmr.4.4.273
Stulberg DL, Hutchinson AG. Molluscum contagiosum and warts. Am Fam Phys. 2003;67(6):1233-40.
Vali A, Ferdowsi F. Evaluation of the efficacy of 50% citric acid solution in plane wart treatment. Indian J Dermatol. 2007;52(2):96-8. DOI: https://doi.org/10.4103/0019-5154.33287
Abdel Meguid AM, Abdel Motaleb AA, Abdel Sadek AM. Cryotherapy vs trichloroacetic acid 90% in treatment of common warts. J Cosm Dermatol. 2019;18(2):608-13. DOI: https://doi.org/10.1111/jocd.12805
Ebrahimi S, Dabiri N, Jamshidnejad E, Sarkari B. Efficacy of 10% silver nitrate solution in the treatment of common warts: a placebo‐controlled, randomized, clinical trial. Int J Dermatol. 2007;46(2):215-7. DOI: https://doi.org/10.1111/j.1365-4632.2007.02955.x
Concannon M, Keogh L, Stephenson J, Parfitt G, Forrest J. A randomized comparative evaluation of clinical and home application to investigate the effectiveness of silver nitrate (AgNO3)(95%) for the treatment of verruca pedis. Int J Pharm Pract. 2001;25(6):421-8. DOI: https://doi.org/10.1111/ijpp.12345
Kwok CS, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane database of systematic reviews. 2012(9):CD001781. DOI: https://doi.org/10.1002/14651858.CD001781.pub3
García-Oreja S, Álvaro-Afonso FJ, Tardáguila-García A, López-Moral M, GarcíaMadrid M, Lázaro-Martínez JL. Efficacy of cryotherapy for plantar warts: A systematic review and meta-analysis. Dermatol Ther. 2022;35(6):e15480. DOI: https://doi.org/10.1111/dth.15480
Yousaf A, Gul S, Zahra A, Aslam A, Khan AN, Hafeez L, et al. Comparison of efficacy of 30% solution of trichloroacetic acid (TCA) with 0.025% tretinoin in the treatment of flat warts at a tertiary care hospital. J Pak Assoc Dermatol. 2021;31(4):600-4.
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. DOI: https://doi.org/10.1111/dth.13559
Jayaprasad S, Subramaniyan R, Devgan S. Comparative Evaluation of Topical 10% Potassium Hydroxide and 30% Trichloroacetic Acid in the Treatment of Plane Warts. Indian J Dermatol. 2016;61(6):634-9. DOI: https://doi.org/10.4103/0019-5154.193670
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