title: The Treatment of Verrucae Pedis Using Falknor's Needling Method: A Review of 46 Cases.
abstract: Human Papilloma Virus (HPV) related verrucae pedis persist, seemingly evading host immune surveillance, yet sometimes disappear with inflammation. The absence, or reduction, of a cellular immune response may explain why verrucae treatments are not uniformly successful and treatment can be difficult even in immune-competent individuals. Little investigation has been undertaken into the potential benefit and efficacy of needling verrucae, a treatment modality causing HPV infected keratinocyte destruction in addition to inducing an assumed enhanced immune response. A review of clinical practice is presented, reporting the treatment method and results of data collected from a retrospective review of 45 patients. Thirty-one (69%) cases demonstrated complete resolution of verrucae following needling treatment. Three patients demonstrated reduction in size and pain whilst 11 showed no improvement. No adverse events were noted. Needling may have a place in the management of verrucae pedis in an adult population but a large scale study utilising objective measures and a control intervention would provide more detailed efficacy data along with a greater understanding of the effects of this treatment on long term immunity.
authors.affiliation: Winchester Podiatry, Winchester, SO23 9QX, UK. belinda@winchesterpodiatry.co.uk.
authors.forename: Belinda
authors.initials: B
authors.lastname: Longhurst
authors.affiliation: Faculty of Health Sciences, University of Southampton, Hampshire, SO17 1BJ, UK. ib@soton.ac.uk.
authors.forename: Ivan
authors.initials: I
authors.lastname: Bristow
keywords: HPV; foot; infection; plantar; verrucae; virus; wart