Pulsed Dye Laser Treatment is Effective in the Treatment of Recalcitrant Viral Warts

SCHELLHAAS, ULRIKE; Gerber, Wolfgang; Hammes, Stefan; Ockenfels, Hans-Michael

doi:10.1111/j.1524-4725.2007.34010.x

Cited by 25 publications

(31 citation statements)

References 25 publications

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“…For another thing, many dermatologists who mostly provide laser therapy have veered away from conventional dermatology and are dedicated to the therapy of cosmetic indications and “treatment” of patients with body dysmorphic disorders. This might be why their interest in treatments of inflammatory dermatological diseases such as CLE and other, not primarily cosmetic–aesthetic dermatological indications seems to have diminished 8–12 …”

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confidence: 99%

Commentary: Treatment of Cutaneous Lupus Erythematosus Using the Pulsed Dye Laser

Raulin

Hammes

2011

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.T he prospective study by Truchuelo Díez and colleagues 1 points the way ahead. For the first time, histologic and immunohistologic examinations have been conducted and their results correlated with the similarly excellent clinical results.The treatment of cutaneous lupus erythematosus (CLE) using the pulsed dye laser (PDL) was described for the first time by the group of Pablo Boixeda and Maria Nunez. 2 Since then (15 years ago!), there have been only a few studies 1-7 on this topic, but they have consistently confirmed the excellent results of the method.The exact reason for the effectiveness of pulsed light at a wavelength of 585-595 nm of PDL in the treatment of CLE lesions is unclear. With laser therapy, the applied light is monochromatic, and there is strong evidence that the induced pathogenic mechanisms are different from those caused by irradiation over an ultraviolet spectrum. 4 The suggested working mechanism of PDL (selective photothermolysis) is selective destruction of the cutaneous microvasculature, which might modulate the inflammatory network, leading to regression of CLE lesions. 1 Legitimate questions are why PDL has not become a standard method or even the criterion standard in CLE therapy and why it has not been included in the official guidelines of dermatologic associations, even though it is a simple and effective method with minor side effects. To answer the questions, an analysis might help, based on a thorough search of the literature in the relevant databases (MEDLINE and the Cochrane Library). The search terms cutaneous lupus erythematosus treatment, cutaneous lupus erythematosus pulsed dye laser, and wrinkle treatment were employed. From 2005 to 2010, we found 547 relevant articles for cutaneous lupus erythematosus (CLE), seven relevant articles with the combination of CLE and PDL, and 191 relevant articles for the cosmetic treatment of wrinkles on these databases.It seems that conservative conventional dermatologists do not see or recognize the achievements of innovative laser therapy or that they simply do not know about them and thus do not implement them in their therapy regime, or it may be they have scruples about offering medically indicated services as direct-payment services because, in most cases, insurance companies do not pay for such therapies. For another thing, many dermatologists who mostly provide laser therapy have veered away from conventional dermatology and are dedicated to the therapy of cosmetic indications and ''treatment'' of patients with body dysmorphic disorders. This might be why their interest in treatments of inflammatory dermatological diseases such as CLE and other, not primarily cosmetic-aesthetic dermatological indications seems to have diminished.

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confidence: 99%

Commentary: Treatment of Cutaneous Lupus Erythematosus Using the Pulsed Dye Laser

Raulin

Hammes

2011

Dermatologic Surgery

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“…Interestingly, PDL has the highest RFI rate, with 74% of patients without recurrences after 6 months. Previous studies showed the importance of PDL for the lowest rate of adverse event, as compared with other lasers, and for the treatment of recalcitrant warts . Nevertheless, considering the availability, costs and the absence of guidelines for PDL, other treatment options should be taken into account even if affected by a 3‐fold higher risk of recurrence (keratolytics and CO 2 laser).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for recurrence after successful treatment of warts: the role of smoking habits

Bencini¹,

Guida

Cazzaniga

et al. 2017

Acad Dermatol Venereol

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“…Furthermore, we assessed the treatment efficacy on recalcitrant warts in this study, which have an expected lower cure rate than simple warts. Several uncontrolled studies have found PDL able to clear 48-93% of simple and/or recalcitrant warts at various locations, and two studies have reported of low cure rates at 0% and 6.5% of warts [5][6][7][8][9][10][11][12][13]15,17,18]. Cure rates observed in these non-randomized, non-controlled studies do not account for the spontaneous resolution of warts and the high risk of bias makes interpretation and validity of these outcomes uncertain.…”

Section: Discussionmentioning

confidence: 99%

“…Newer, non-destructive interventions such as the pulsed dye laser (PDL) and intense pulsed light (IPL) have been suggested for treatment of recalcitrant warts [5][6][7][8][9][10][11][12][13][14][15]. The mechanism of action is assumed to be selective destruction of superficially papillary capillaries of the wart as well as thermal injury of the heat-sensitive HPV [5].…”

Section: Introductionmentioning

confidence: 99%

Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation

Togsverd‐Bo¹,

Gluud²,

Winkel³

et al. 2010

Lasers Surg Med

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Background and Objectives: Treatment of recalcitrant viral warts remains a therapeutic challenge. Intense pulsed light (IPL) has been suggested effective to clear wart tissue. The objective was in a randomized controlled trial to assess the efficacy of paring followed by IPL versus paring alone for recalcitrant hand and foot warts. Materials and Methods: Eighty-nine patients with recalcitrant hand and foot warts were included and randomized (1:1) to three treatments at 3-week intervals with either paring of warts followed by IPL or paring of warts alone. IPL was given with the Ellipse Flex IPL system (Danish Dermatologic Development A/S, Hørsholm, Denmark, 400-950 nm, 5.5 millisecond pulse duration in double pulses with a 2 millisecond interval, 26.0-32.5 J/ cm 2 repetitive passes). The primary outcome was complete and partial clearance of warts evaluated by blinded photo assessment at 6 weeks after final treatment. Secondary outcomes were treatment related pain and adverse reactions. Results: We found no significant difference in clearance of warts between the two intervention groups (OR 1.64, 95% confidence interval 0.62-4.38). Paring followed by IPL resulted in complete or partial clearance of wart tissue in nine (22%) and five patients (12.2%) versus five (13.5%) and four patients (10.8%) from paring alone. Mostly plantar warts were treated (92.1%). The pain intensity after paring and IPL was moderate and significantly higher than the pain intensity after paring alone (P<0.0005). No adverse reactions were observed from the two interventions. Conclusion: Paring followed by IPL did not differ significantly from paring alone in clearance of recalcitrant hand and foot warts but caused significantly more pain.

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Pulsed Dye Laser Treatment is Effective in the Treatment of Recalcitrant Viral Warts

Abstract: Pulsed dye laser treatment is effective and safe in the treatment of recalcitrant viral warts.

Cited by 25 publications

References 25 publications

Commentary: Treatment of Cutaneous Lupus Erythematosus Using the Pulsed Dye Laser

Commentary: Treatment of Cutaneous Lupus Erythematosus Using the Pulsed Dye Laser

Risk factors for recurrence after successful treatment of warts: the role of smoking habits

Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation

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