Laser therapy in cutaneous and genital warts: A review article

Abstract

Traditional treatment modalities for wart require long‐term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non‐genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium‐yttrium‐aluminum‐garnet (Nd: YAG), 3 erbium‐doped yttrium‐aluminum‐garnet (Er: YAG), 14 carbon dioxide (CO2) laser and one systematic review. Complete response rates were different in terms of laser type used (0%‐100%, 9.1%‐100%, 83.3%‐100%, and 59.15%‐100% for PDL, Nd: YAG, Er: YAG, and CO2 laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers.

Identification of Immunodominant T-lymphocyte Epitope Peptides in HPV 1, 2 and 3 L1 Protein for Novel Cutaneous Wart Vaccine

“…Existing wart treatments have low clearance rates and high recurrence rates, and as such, are increasingly seen as non-viable options for recalcitrant infections [17]. Licensed VLP-based HPV vaccines on the market target high-risk oncogenic HPV types, and while studies have reported limited positive responses against anogenital and cutaneous warts, their efficacy is hindered by a lack of specific coverage for verrucae-causing types, namely, HPV types 1, 2, and 3 [57, 58].…”

“…Studies have proven salicylic acid to be somewhat more effective than placebo [16]. Nonetheless, conventional treatments can be painful and inefficient, with low clearance rates and high recurrence rates [17]. Moreover, treatment has the potential to cause moderate to severe scarring, leading to severe deficits in cosmesis [3].…”

“…These risks have led many physicians to opt for a wait-and-see approach, leaving patients with cosmetic insecurity and physical discomfort. Others have turned to alternative techniques such as laser therapy and oral isotretinoin, but issues over recurrent infection remain [17–19]. Evidently, there is a need for a prophylactic, nondestructive wart treatment.…”

“…Studies have proven salicylic acid to be somewhat more effective than placebo [16]. Nonetheless, conventional treatments can be painful and inefficient, with low clearance rates and high recurrence rates [17].…”

Penggunaan Laser CO2 Pada Penderita Kondiloma Akuminata Perianal dan HIV

“…(18)(19)(20) Jika dibandingkan dengan terapi bedah listrik Clearance rate bisa mencapai 61-94% dan tingkat rekurensi mencapai 22 %, efek samping dan komplikasi yang muncul dapat berupa rasa nyeri setelah tindakan, timbulnya jaringan parut dan infeksi, maka dengan bedah laser CO2, (14,(18)(19)(20) luka infeksi lebih cepat sembuh dan hanya sedikit menimbulkan jaringan parut, serta angka rekurensi lebih rendah. (11,14,19,20) Edukasi tentang penyebab penyakitnya dan sumber penularanya melalui kontak seksual adalah hal sangat penting yang harus diberikan pada pasien. Baik penularan HIV dan HPV dapat disebabkan oleh perilaku seksual dan kedua penyakit ini sangat berkaitan erat bahkan menjadi faktor pendukung.…”