SummaryBackground Cutaneous warts have a cure rate after therapy of no more than approximately 50%. Recently, we developed and validated a standard assessment tool for warts (Cutaneous WARTS diagnostic tool, CWARTS) based on phenotypical characteristics. Objectives To assess whether patient and morphological wart characteristics predict the human papillomavirus (HPV) type in a specific wart and whether these characteristics as well as the HPV type predict a favourable treatment response. Methods Photographs were used to score nine morphological wart characteristics using the newly developed CWARTS tool. Genotyping of 23 wart-associated HPV types was performed using the hyperkeratotic skin lesion-polymerase chain reaction/multiplex genotyping assay. The results were correlated with a favourable response to treatment with monochloroacetic acid, cryotherapy or a combination of cryotherapy and salicylic acid. Odds ratios were calculated using logistic regression in a generalized estimating equations model. Results Black dots (capillary thrombosis) strongly predicted the presence of any HPV type in a wart. From all characteristics tested, the HPV type most strongly predicted the treatment response when the warts were treated with monochloroacetic acid or a combination of cryotherapy and salicylic acid with a significantly decreased treatment response if the warts contained HPVs of the alpha genus (HPV2, HPV27 or HPV57). When cryotherapy alone was used for common warts, HPV type did not play a role, but cryotherapy was less effective in the presence of callus and when the wart was located deeper in the skin. Conclusions Morphological characteristics of the warts and the HPV genotype influence treatment outcome and thus potentially influence future treatment decisions for common and plantar warts.

SummaryBackground The clinical appearance of cutaneous warts is highly variable and not standardized. Objectives To develop and validate a reproducible clinical tool for the standardized assessment of cutaneous warts to distinguish these lesions accurately. Methods Nine morphological characteristics were defined and validated regarding intra-and interobserver agreement. Based on literature and semistructured interviews, a systematic dichotomous assessment tool, the Cutaneous WARTS (CWARTS) diagnostic tool was developed. The validation consisted of two independent parts performed with photographs from the recent WARTS-2 trial. In part A, the CWARTS diagnostic tool was tested by 28 experienced physicians who assessed photographs of 10 different warts to investigate interobserver concordance. In part B, morphological characteristics were validated by masked and independent scoring of 299 photographs by six different observers. Part B also entailed reassessment of the photographs after at least 1 week. The primary outcome measurement was the intraclass correlation coefficient (ICC). Results Presence of black dots (capillary thrombosis) had the greatest ICC (0Á85) for interobserver agreement in part A, followed by arrangement (0Á65), presence of border erythema (0Á64) and sharpness of the border (0Á60). In part B, results were similar for interobserver agreement with presence of black dots having the highest ICC (0Á68), followed by border erythema (0Á64), arrangement (0Á58) and colour (0Á55). For intraobserver agreement, presence of black dots had the highest agreement (0Á70), followed by presence of border erythema (0Á694) and colour (0Á59). Conclusions Wart phenotype can be reliably assessed using the CWARTS diagnostic tool.

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Background Research has shown that sad mood inductions (SMIs) have effects on cognition in depression-vulnerable samples (e.g., recovered depressed patients), but not in never-depressed individuals. A recent study however, found that an SMI followed by a brief period of suppressing negative thoughts affects subsequent information processing in never-depressed individuals, even while the sad mood had already dissipated. We investigated the relevance of this finding for depression, and also whether this effect would be robust against minor procedural variations. Method 32 recovered depressed and 32 never-depressed individuals underwent an SMI followed by a writing task during which either instructions to suppress negative thoughts or no instructions were given. Finally, participants completed a scrambled sentences task (SST). Results Recovered depressed participants unscrambled significantly more negative sentences on the SST than the control group. Thought suppression did not affect performance in either group. SST performance correlated with various aspects of cognitive reactivity. Conclusion A brief period of thought suppression during sadness does not have an effect on cognition in never-depressed nor in recovered depressed individuals.

Summary 并非所有皮肤疣的症状都相同。这项在荷兰开展的研究旨在开发并测试精确的诊断工具,以帮助临床医生诊断疣。该项研究的作者根据各种文献和专家访谈定义了九大外观特征,进而开发出了皮肤疣诊断工具(CWARTS诊断工具)。该项研究包括两个部分。在第一个部分(部分A)中,28名研究人员(“观察员”)评估了10种疣的照片,然后该团队调查了这些研究人员之间的共识程度。在第二个部分(部分B)中,6名研究人员再次评估了299种疣的照片,这次该团队测试了这6名观察员的第一次和第二次(相隔一周或更久)评估结果的一致性。对于疣的九种特征,该团队计算了一种广泛使用的可靠性指数,称为同类相关系数(ICC)。换句话说,如果ICC较高,则说明观察员之间达成共识的程度较高或者观察员的结果更加一致。观察员对存在黑点的这一特征的共识程度最高(达到0.85),疣的排列次之(0.65),接着是疣的边缘有红斑(0.64)以及边缘的对比(0.60)。在研究的部分B中,这些结果较为相似。对于第一次和第二次评估之间的一致性,存在黑点这一特征再一次位列第一,其次是边缘有红斑(0.64)以及疣的颜色(0.55)。作者们通过此项研究论证得出,可以利用CWARTS诊断工具可靠地评估皮肤疣的外观。