Current choices in the treatment of cutaneous warts: a survey among Dutch GP.
BACKGROUND
GPs apply several treatments for patients with cutaneous warts. Available evidence recommends salicylic acid application.


OBJECTIVE
We investigated whether current choices of GPs in the treatment of warts are in agreement with available evidence.


METHODS
A nationwide random sample of 700 Dutch GPs received a postal questionnaire on their choices in the treatment of warts. In addition, factors that influence these choices, their view on the effectiveness of treatments and their view on the natural history of warts were assessed.


RESULTS
The questionnaire was returned by 280 GPs (40%). Cryotherapy was first choice treatment in 73% of GPs for hand warts, 49% of GPs for plantar warts and 72% of GPs for warts on other locations. Salicylic acid application or the combination of cryotherapy and salicylic acid were used less frequently, followed by an expectant awaiting policy and (electro) surgery. Most important factors influencing their treatment choice were GPs' routine and GPs' views on effectiveness.


CONCLUSIONS
In contrast to available evidence, most GPs apply cryotherapy as first choice treatment of cutaneous warts. Pragmatic high-quality trials on the effectiveness of wart treatments conducted in primary care might solve this discrepancy between evidence and practice.
Bruggink
Sjoerd C
SC
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. s.c.bruggink@lumc.nl
Waagmeester
Sanneke C
SC
Gussekloo
Jacobijn
J
Assendelft
Willem J J
WJ
Eekhof
Just A H
JA
D000279:Administration, Cutaneous; D002983:Clinical Competence / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D017679:Cryotherapy / Q000706:statistics & numerical data; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D020156:Salicylic Acid / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014860:Warts / Q000188:drug therapy / Q000628:therapy*
D020156:Salicylic Acid