Efficacy of pulsed-dye laser for viral warts--an internal audit.
Pulsed-dye laser (PDL) surgery is a recognized treatment of viral warts. Initial studies in 1993 by Tan et al achieved a 72% cure rate for 39 patients after a mean of 1.68 treatments. Since then, conflicting response rates ranging from 47-95% have been reported. The records of 44 patients, who attended the Laser Unit at St. James's Hospital between January 1999 to June 2000, were reviewed. Follow-up was conducted by telephone interview or questionnaire. Twenty-eight (64%) patients identified for the study responded. The average number of treatments was 4 (range 1-12) and mean treatment intervals were 4.9 weeks (3-10). Our results showed 64% complete clearance of all the areas treated, and 46% complete clearance of the 13 areas identified as recalcitrant. Rates for complete clearance varied with anatomic site: 73% for the face, 68% for the hands, and 40% for feet. Seventy-eight percent (7/9) of periungal warts completely cleared, and 70% (7/10) mosaic warts cleared. Twenty-five percent of the patients complained of severe pain during treatment. Post-operative complications were few, and rarely affected the patients' lifestyle. The recurrence of warts, in weeks to months following the last treatment, was reported by 36% of the patients. Seventy-nine percent of patients were satisfied with the treatment they were given. PDL may be useful in treatment of refractory warts in selected patient populations. The study identified a need to address pain control in a significant number of patients.
Department of Plastic and Reconstructive Surgery, St. James's Hospital, Dublin 8, Ireland.
C
C
Wu
S
S
Langan
M
M
Kilmurray
D
D
Lawlor
R
R
Watson
D000293:Adolescent; D000328:Adult; D002648:Child; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014860:Warts / Q000601:surgery*