Combination of carbon dioxide laser therapy and artificial dermis application in plantar warts: human papillomavirus DNA analysis after treatment.
BACKGROUND
Various laser therapies have been used to treat viral warts, and numerous successful results have been reported, but plantar warts are notoriously difficult to treat and eradicate.


METHODS
This study included 35 lesions in 31 patients (17 female, 14 male) with plantar warts. We used a carbon dioxide (CO₂) laser for incisions, and the defect was covered with artificial dermis. Follow-up periods ranged from 3 to 12 months. Overall, we examined the presence or absence of human papillomaviruses (HPVs) DNA in the lesional skin of all cases and at the excisional site after treatment in 20 cases.


RESULTS
Thirty-one of 35 lesions (88.6%) achieved complete clearance after one treatment session. We observed local recurrence in four lesions (11.4%). The application of salicylic acid was effective in treating minor recurrent cases. After complete remission, HPV DNA was not detected in the upper epidermis of the postoperative site. No significant scars or severe pain were seen in any patients.


CONCLUSIONS
A combination of CO₂ laser therapy and artificial dermis application effectively treated the majority of plantar warts after one treatment, with complete and rapid clearance and no persistent pain. The authors have indicated no significant interest with commercial supporters.
Mitsuishi
Tsuyoshi
T
Department of Dermatology, Nippon Medical School, Tokyo, Japan. tmitsu@nms.ac.jp
Sasagawa
Toshiyuki
T
Kato
Toshihiko
T
Iida
Kazumi
K
Ueno
Takashi
T
Ikeda
Masumi
M
Ninomiya
Risa
R
Wakabayashi
Toshiteru
T
Kawasaki
Hirofumi
H
Motoki
Tomoteru
T
Kawana
Seiji
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003131:Combined Modality Therapy; D015344:DNA Probes, HPV; D005260:Female; D005533:Foot Dermatoses / Q000601:surgery* / Q000821:virology; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017768:Skin, Artificial; D014860:Warts / Q000601:surgery* / Q000821:virology; D055815:Young Adult
D015344:DNA Probes, HPV