Brodawki podeszwowe – Rokowania, prognozy i postęp choroby

Brodawki podeszwowe
Rokowania, prognozy i postęp choroby

Brodawki podeszwowe, wywołane przez wirusa HPV, lokalizują się na podeszwowych powierzchniach stóp i często ustępują samoistnie, zwłaszcza u dzieci w ciągu 1-2 lat, natomiast u dorosłych proces ten może trwać dłużej. Szacuje się, że do 80% zmian ustępuje w ciągu 2 lat, a prawdopodobieństwo samoistnego ustąpienia w ciągu kilku miesięcy wynosi około 25%. Leczenie obejmuje głównie krioterapię ciekłym azotem oraz preparaty z 50% kwasem salicylowym, które wykazują podobną skuteczność – całkowite ustąpienie brodawek po 12 tygodniach obserwowano u około 14% pacjentów. Preparaty dostępne bez recepty mogą eliminować zmiany już w ciągu dwóch tygodni, choć nie jest to regułą. Brodawki mogą być bolesne i wpływać negatywnie na jakość życia pacjenta, a nawroty po leczeniu są możliwe, co wynika z braku skutecznych metod zapobiegania reinfekcji HPV.

Prognoza brodawek podeszwowych (Plantar warts Prognosis)

Naturalny przebieg choroby
Skuteczność metod terapeutycznych
Predykcja odpowiedzi na leczenie
Nawroty po leczeniu
Postępowanie w przypadkach opornych na leczenie
Zalecenia dotyczące postępowania
Kolejne rozdziały

Prognoza brodawek podeszwowych (Plantar warts Prognosis)

Brodawki podeszwowe (plantar warts) to zmiany skórne wywołane przez wirusa brodawczaka ludzkiego (HPV), które lokalizują się na podeszwowych powierzchniach stóp. Rokowanie w przypadku brodawek podeszwowych jest zazwyczaj dobre, jednak przebieg choroby i skuteczność leczenia mogą być zróżnicowane w zależności od wielu czynników.¹²

Naturalny przebieg choroby

Brodawki podeszwowe często ustępują samoistnie bez interwencji medycznej, co jest wynikiem reakcji układu odpornościowego na infekcję HPV. Należy jednak podkreślić, że proces ten może być długotrwały:¹²

U dzieci samoistne ustąpienie zmian zazwyczaj następuje w ciągu 1-2 lat
U dorosłych okres ten może być znacznie dłuższy
Szacuje się, że do 80% przypadków brodawek podeszwowych ustępuje samoistnie w ciągu 2 lat
Prawdopodobieństwo samoistnego ustąpienia w okresie kilku miesięcy wynosi około 25%

³⁴

Brodawki podeszwowe mogą być bolesnym schorzeniem, niekiedy związanym z miejscowym krwawieniem i wysiękiem, co negatywnie wpływa na jakość życia pacjenta w okresie aktywnej infekcji.⁵⁶

Skuteczność metod terapeutycznych

W leczeniu brodawek podeszwowych stosuje się różne metody, przy czym najczęściej wykorzystywane to krioterapia i preparaty zawierające kwas salicylowy. Badania porównawcze tych metod wskazują na zbliżoną skuteczność:⁷

Krioterapia ciekłym azotem wykazuje podobną skuteczność jak samodzielne stosowanie przez pacjenta 50% kwasu salicylowego
Całkowite ustąpienie wszystkich brodawek podeszwowych po 12 tygodniach leczenia obserwowano u około 14% pacjentów, zarówno w grupie leczonej krioterapią, jak i kwasem salicylowym
Preparaty dostępne bez recepty mogą eliminować brodawki podeszwowe już w ciągu dwóch tygodni, choć nie jest to regułą

⁸⁹

Predykcja odpowiedzi na leczenie

W ostatnich latach pojawiły się nowe metody przewidywania skuteczności leczenia brodawek podeszwowych, które mogą pomóc w optymalizacji wyboru terapii dla konkretnego pacjenta:¹⁰¹¹

Algorytmy uczenia maszynowego

Badania nad wykorzystaniem algorytmów uczenia maszynowego do przewidywania skuteczności leczenia brodawek wykazały obiecujące wyniki:¹²¹³¹⁴

Średnia dokładność przewidywania skuteczności immunoterapii wynosi 88,6% ± 8,0%
Średnia dokładność przewidywania skuteczności krioterapii wynosi 94,6% ± 4,0%
Modele uczenia maszynowego zwracają nieprawidłowe wyniki w mniej niż 6,3% przypadków
Pozwala to na bardziej zindywidualizowane podejście do wyboru metody leczenia

¹⁵¹⁶

Cechy dermoskopowe jako predyktory odpowiedzi na krioterapię

Dermoskopia, oprócz roli diagnostycznej, może również służyć do przewidywania odpowiedzi na leczenie krioterapią:¹⁷

Korzystną odpowiedź na krioterapię przewidują następujące cechy dermoskopowe:
- Obecność kropek
- Wyraźne łuski powierzchniowe
- Dobrze zdefiniowane granice zmiany
W przypadku brodawek podeszwowych pozytywną odpowiedź na krioterapię przewiduje obecność rumienia okołozmianowego
Brodawki zwykłe (common warts) lepiej odpowiadają na krioterapię, gdy wykazują cechy unaczynienia i wyraźnych łusek powierzchniowych

¹⁸

Nawroty po leczeniu

Istotnym aspektem prognozy brodawek podeszwowych jest możliwość występowania nawrotów po skutecznym leczeniu:¹⁹²⁰

Po zakażeniu HPV nie ma pewnego sposobu na zapobieganie nawrotom brodawek podeszwowych
Brodawki po leczeniu mogą pojawić się ponownie w tym samym miejscu lub w innej części podeszwy stopy
Niektórzy pacjenci po skutecznym leczeniu nigdy więcej nie doświadczają nawrotu brodawek
Pojawienie się nowej brodawki po leczeniu może wynikać z ponownej ekspozycji na wirusa HPV

²¹²²

Postępowanie w przypadkach opornych na leczenie

Niektóre brodawki podeszwowe mogą być oporne na leczenie, co stanowi wyzwanie terapeutyczne:²³

W przypadku oporności na standardowe metody leczenia może być rozważane usunięcie chirurgiczne jako ostateczna opcja terapeutyczna
Skuteczność chirurgicznego leczenia brodawek podeszwowych nie została dokładnie określona w literaturze naukowej
Zabieg chirurgiczny również może okazać się nieskuteczny
Alternatywą dla dalszego aktywnego leczenia może być zaprzestanie terapii i oczekiwanie na samoistne ustąpienie zmiany
Opisywano przypadki stosowania szczepionek przeciwko HPV w leczeniu opornych brodawek, co może indukować szerszą odpowiedź immunologiczną, jednak podejście to nie zostało ocenione w randomizowanych badaniach klinicznych

²⁴

Zalecenia dotyczące postępowania

Biorąc pod uwagę naturalny przebieg choroby i skuteczność dostępnych metod leczenia, w przypadku brodawek podeszwowych można rozważyć następujące podejścia:²⁵²⁶

Zachowawcze postępowanie jest uzasadnioną opcją, szczególnie przy uwzględnieniu częstego samoistnego ustępowania zmian
Brak jest oficjalnych wytycznych dermatologicznych, które określałyby skuteczność poszczególnych metod leczenia u indywidualnego pacjenta
Zarówno krioterapia, jak i immunoterapia nie zawsze są skuteczne i mogą być związane z nieprzyjemnymi działaniami niepożądanymi
Wybór między samodzielnym stosowaniem preparatów z kwasem salicylowym a procedurami wykonywanymi przez lekarza (np. krioterapią) powinien uwzględniać preferencje pacjenta, dostępność metod oraz ich koszt

²⁷²⁸²⁹

Podsumowując, rokowanie w przypadku brodawek podeszwowych jest zazwyczaj dobre, z wysokim odsetkiem samoistnych remisji w dłuższej perspektywie czasowej. Dostępne metody leczenia wykazują umiarkowaną skuteczność, a wybór optymalnej terapii powinien być indywidualizowany. Nowoczesne metody predykcji odpowiedzi na leczenie, takie jak algorytmy uczenia maszynowego i dermoskopia, mogą w przyszłości przyczynić się do optymalizacji wyboru terapii i poprawy wyników leczenia.³⁰³¹

Kolejne rozdziały

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Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Plantar Warts: Symptoms, Causes, Treatment & Removal
https://my.clevelandclinic.org/health/diseases/24899-plantar-warts
The outlook for people with plantar warts is good. Over-the-counter treatments can get rid of plantar warts as quickly as two weeks. Without treatment, your immune system usually fights off the HPV infection after one to two years. […] But once you have HPV, there’s no sure way to keep plantar warts from returning. After treatment, plantar warts can reappear at the same location or appear in another part of the bottom of your foot. Some people get rid of plantar warts and never have them again.
#1 Plantar warts – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697
Most plantar warts are harmless and go away without treatment, though it may take a year or two in children, and even longer in adults. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV.
#2 Plantar warts – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697
Most plantar warts are harmless and go away without treatment, though it may take a year or two in children, and even longer in adults. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV.
#2
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#3
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#4 Plantar warts – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697
Most plantar warts are harmless and go away without treatment, though it may take a year or two in children, and even longer in adults. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV.
#5 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
Warts can be extremely painful conditions that may be associated with localised bleeding and discharge. […] Warts are commonly treated by cryotherapy or immunotherapy. […] However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient. […] This study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy. […] The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal.
#6 :: AD :: Annals of Dermatology
https://anndermatol.org/DOIx.php?id=10.5021/ad.2021.33.4.345
Warts can be an extremely painful condition that may be associated with localised bleeding and discharge. […] Cryotherapy and immunotherapy do not always work and there are no official dermatological guideline that exist that may be used to determine the efficacy of these methods on an individual patient basis. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#7 Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial | The BMJ
https://www.bmj.com/content/342/bmj.d3271
There was no evidence of a difference between the salicylic acid and cryotherapy groups in the proportions of participants with complete clearance of all plantar warts at 12 weeks (17/119 (14%) v 15/110 (14%), difference 0.65% (95% CI 8.33 to 9.63), P=0.89). […] Salicylic acid and the cryotherapy were equally effective for clearance of plantar warts. […] We found no evidence that cryotherapy is more effective than patient self treatment with 50% salicylic acid for the treatment of plantar warts. […] There is no evidence to suggest that cryotherapy with liquid nitrogen was more clinically effective than patient self treatment with 50% salicylic acid in clearing plantar warts.
#8 Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial | The BMJ
https://www.bmj.com/content/342/bmj.d3271
There was no evidence of a difference between the salicylic acid and cryotherapy groups in the proportions of participants with complete clearance of all plantar warts at 12 weeks (17/119 (14%) v 15/110 (14%), difference 0.65% (95% CI 8.33 to 9.63), P=0.89). […] Salicylic acid and the cryotherapy were equally effective for clearance of plantar warts. […] We found no evidence that cryotherapy is more effective than patient self treatment with 50% salicylic acid for the treatment of plantar warts. […] There is no evidence to suggest that cryotherapy with liquid nitrogen was more clinically effective than patient self treatment with 50% salicylic acid in clearing plantar warts.
#9 Plantar Warts: Symptoms, Causes, Treatment & Removal
https://my.clevelandclinic.org/health/diseases/24899-plantar-warts
The outlook for people with plantar warts is good. Over-the-counter treatments can get rid of plantar warts as quickly as two weeks. Without treatment, your immune system usually fights off the HPV infection after one to two years. […] But once you have HPV, there’s no sure way to keep plantar warts from returning. After treatment, plantar warts can reappear at the same location or appear in another part of the bottom of your foot. Some people get rid of plantar warts and never have them again.
#10 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
Warts can be extremely painful conditions that may be associated with localised bleeding and discharge. […] Warts are commonly treated by cryotherapy or immunotherapy. […] However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient. […] This study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy. […] The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal.
#11 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] The results indicate less than 6.3% of the time, the models return incorrect results. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#12 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
Warts can be extremely painful conditions that may be associated with localised bleeding and discharge. […] Warts are commonly treated by cryotherapy or immunotherapy. […] However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient. […] This study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy. […] The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal.
#13 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] The results indicate less than 6.3% of the time, the models return incorrect results. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#14 :: AD :: Annals of Dermatology
https://anndermatol.org/DOIx.php?id=10.5021/ad.2021.33.4.345
Warts can be an extremely painful condition that may be associated with localised bleeding and discharge. […] Cryotherapy and immunotherapy do not always work and there are no official dermatological guideline that exist that may be used to determine the efficacy of these methods on an individual patient basis. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#15 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] The results indicate less than 6.3% of the time, the models return incorrect results. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#16 :: AD :: Annals of Dermatology
https://anndermatol.org/DOIx.php?id=10.5021/ad.2021.33.4.345
Warts can be an extremely painful condition that may be associated with localised bleeding and discharge. […] Cryotherapy and immunotherapy do not always work and there are no official dermatological guideline that exist that may be used to determine the efficacy of these methods on an individual patient basis. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#17 Predictive dermoscopic features of cryotherapy treatment response in cutaneous warts | Scientific Reports
https://www.nature.com/articles/s41598-024-80608-7
The utility of dermoscopy for the diagnosis of cutaneous warts is well known. However, its role in predicting the outcome of cryotherapy for cutaneous warts remains unexplored. […] Dermoscopic features, such as dots, marked surface scales, and well-defined margins, predict a favorable cryotherapy response in cutaneous warts. Plantar warts respond positively in the presence of perilesional erythema, whereas common warts exhibit vascularity and marked surface scales for a better response to cryotherapy. […] This study provides valuable insights into the predictive role of dermoscopy in determining the treatment response of cutaneous warts to cryotherapy. We found that specific dermoscopic features, such as the presence of dots, marked surface scales, and well-defined margins, are associated with a favorable response to cryotherapy in cutaneous warts.
#18 Predictive dermoscopic features of cryotherapy treatment response in cutaneous warts | Scientific Reports
https://www.nature.com/articles/s41598-024-80608-7
The utility of dermoscopy for the diagnosis of cutaneous warts is well known. However, its role in predicting the outcome of cryotherapy for cutaneous warts remains unexplored. […] Dermoscopic features, such as dots, marked surface scales, and well-defined margins, predict a favorable cryotherapy response in cutaneous warts. Plantar warts respond positively in the presence of perilesional erythema, whereas common warts exhibit vascularity and marked surface scales for a better response to cryotherapy. […] This study provides valuable insights into the predictive role of dermoscopy in determining the treatment response of cutaneous warts to cryotherapy. We found that specific dermoscopic features, such as the presence of dots, marked surface scales, and well-defined margins, are associated with a favorable response to cryotherapy in cutaneous warts.
#19 Plantar Warts: Symptoms, Causes, Treatment & Removal
https://my.clevelandclinic.org/health/diseases/24899-plantar-warts
The outlook for people with plantar warts is good. Over-the-counter treatments can get rid of plantar warts as quickly as two weeks. Without treatment, your immune system usually fights off the HPV infection after one to two years. […] But once you have HPV, there’s no sure way to keep plantar warts from returning. After treatment, plantar warts can reappear at the same location or appear in another part of the bottom of your foot. Some people get rid of plantar warts and never have them again.
#20 Plantar warts – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697
Most plantar warts are harmless and go away without treatment, though it may take a year or two in children, and even longer in adults. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV.
#21 Plantar Warts: Symptoms, Causes, Treatment & Removal
https://my.clevelandclinic.org/health/diseases/24899-plantar-warts
The outlook for people with plantar warts is good. Over-the-counter treatments can get rid of plantar warts as quickly as two weeks. Without treatment, your immune system usually fights off the HPV infection after one to two years. […] But once you have HPV, there’s no sure way to keep plantar warts from returning. After treatment, plantar warts can reappear at the same location or appear in another part of the bottom of your foot. Some people get rid of plantar warts and never have them again.
#22 Plantar warts – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697
Most plantar warts are harmless and go away without treatment, though it may take a year or two in children, and even longer in adults. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV.
#23
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#24
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#25
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#26 Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial | The BMJ
https://www.bmj.com/content/342/bmj.d3271
There was no evidence of a difference between the salicylic acid and cryotherapy groups in the proportions of participants with complete clearance of all plantar warts at 12 weeks (17/119 (14%) v 15/110 (14%), difference 0.65% (95% CI 8.33 to 9.63), P=0.89). […] Salicylic acid and the cryotherapy were equally effective for clearance of plantar warts. […] We found no evidence that cryotherapy is more effective than patient self treatment with 50% salicylic acid for the treatment of plantar warts. […] There is no evidence to suggest that cryotherapy with liquid nitrogen was more clinically effective than patient self treatment with 50% salicylic acid in clearing plantar warts.
#27 :: AD :: Annals of Dermatology
https://anndermatol.org/DOIx.php?id=10.5021/ad.2021.33.4.345
Warts can be an extremely painful condition that may be associated with localised bleeding and discharge. […] Cryotherapy and immunotherapy do not always work and there are no official dermatological guideline that exist that may be used to determine the efficacy of these methods on an individual patient basis. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. […] All the results obtained indicate the machine learning models created are efficient in predicting the treatment outcomes of immunotherapy and cryotherapy for wart removal.
#28 Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial | The BMJ
https://www.bmj.com/content/342/bmj.d3271
There was no evidence of a difference between the salicylic acid and cryotherapy groups in the proportions of participants with complete clearance of all plantar warts at 12 weeks (17/119 (14%) v 15/110 (14%), difference 0.65% (95% CI 8.33 to 9.63), P=0.89). […] Salicylic acid and the cryotherapy were equally effective for clearance of plantar warts. […] We found no evidence that cryotherapy is more effective than patient self treatment with 50% salicylic acid for the treatment of plantar warts. […] There is no evidence to suggest that cryotherapy with liquid nitrogen was more clinically effective than patient self treatment with 50% salicylic acid in clearing plantar warts.
#29
https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx
Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. […] It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25% over a period of a few months. […] Eventually, most warts will resolve without treatment, but this may take several years. […] For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the alternative option of ceasing active treatment of the wart can be discussed with the patient. […] There is little data available on the success rates of surgical approaches to plantar wart treatment. […] These cases suggest that the vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.
#30 The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal
https://pmc.ncbi.nlm.nih.gov/articles/PMC8273329/
Warts can be extremely painful conditions that may be associated with localised bleeding and discharge. […] Warts are commonly treated by cryotherapy or immunotherapy. […] However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient. […] This study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy. […] The average accuracy of the immunotherapy prediction was 88.6%8.0% while the same measure for cryotherapy prediction was 94.6%4.0%. […] This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal.
#31 Predictive dermoscopic features of cryotherapy treatment response in cutaneous warts | Scientific Reports
https://www.nature.com/articles/s41598-024-80608-7
The utility of dermoscopy for the diagnosis of cutaneous warts is well known. However, its role in predicting the outcome of cryotherapy for cutaneous warts remains unexplored. […] Dermoscopic features, such as dots, marked surface scales, and well-defined margins, predict a favorable cryotherapy response in cutaneous warts. Plantar warts respond positively in the presence of perilesional erythema, whereas common warts exhibit vascularity and marked surface scales for a better response to cryotherapy. […] This study provides valuable insights into the predictive role of dermoscopy in determining the treatment response of cutaneous warts to cryotherapy. We found that specific dermoscopic features, such as the presence of dots, marked surface scales, and well-defined margins, are associated with a favorable response to cryotherapy in cutaneous warts.