BACKGROUNDGenital warts are caused by human papillomavirus infection and represent one of
the most common sexually transmitted diseases. Many infections are transient but
the virus may recur, persist, or become latent. To date, there is no effective
antiviral treatment to eliminate HPV infection and most therapies are aimed at the
destruction of visible lesions. Potassium hydroxide is a strong alkali that has
been shown to be safe and effective for the treatment of genital warts and
molluscum contagiosum. Cryotherapy is considered one of the most established
treatments for genital warts. No comparative trials have been reported to date on
the use of potassium hydroxide for genital warts.OBJECTIVEA prospective, open-label, randomized clinical trial was conducted to compare
topical potassium hydroxide versus cryotherapy in the treatment of genital warts
affecting immunocompetent, sexually active men.METHODSOver a period of 10 months, 48 patients were enrolled. They were randomly divided
into two groups and selected on an alternative basis for either potassium
hydroxide therapy or cryotherapy. While response to therapy did not differ
substantially between both treatment modalities, side effects such as local pain
and post-treatment hypopigmentation were considerably more prevalent in the groups
treated using cryotherapy.RESULTIn our study, potassium hydroxide therapy proved to be at least as effective as
cryotherapy and offered the benefit of a better safety profile.CONCLUSIONTopical 5% potassium hydroxide presents an effective, safe, and low-cost treatment
modality for genital warts in men and should be included in the spectrum of
therapies for genital warts.
Local anesthesia is a routine procedure in dermatological practice. This chapter deals with the basic principles of pharmacology and pharmacodynamics related to the most commonly used anesthetics in dermatology as well as its side effects, the most common anesthetic solutions, anesthesia techniques, and topical anesthesia.
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