The Overlapped Triple Circle Pulse Technique with Nd:YAG Laser for Refractory Hand Warts

Abstract

Long-pulsed Nd:YAG laser treatment was observed to be a safe, rapid, and effective method for treating recalcitrant hand warts.

Treatment Of Verruca Vulgaris with Long Pulsed Nd:YAG Laser 1064 nm In Iraqi Patients

“…Ugur Anil Bingol et al (19) study included 51 patients who were treated for 146 recalcitrant hand warts using 1064 nm long-pulsed Nd:YAG laser as follows: spot size, 3 mm; pulse duration, 23 ms; fluence, 180-200 J/cm2, the laser treatment method is novel because each treated wart was aligned at the intersection point of the circles of 3 laser pulses per session. Results of this study, 88.35% were successfully treated with one session and 100% of those that required a second treatment session were treated successfully, based on the 12 month follow-up examination.…”

Human Papillomavirus Infection: Management and Treatment

“…There was no recurrence in 12 months follow-up, no major side effects, no nail dystrophy or severe post-treatment scarring. Hyperpigmentation was present in 5.48% patients [77].…”

“…The circle of pulses given in that way that the three circles overlapped each other only on the site of verruca-so that highest level of energy reached only to the wart. The adjacent tissue can avoid unintended tissue damage [77]. All lesions subsided, 88.35% lesions in one laser session, remaining patients were required two laser sessions-those lesions were periungual and palmar.…”

“…A long pulsed Nd:YAG laser emits 1064 nm wavelength light, in infrared spectrum, in longer wavelength with lower haemoglobin, and melanin absorption coefficients allows deeper delivery of higher energy in hyperkeratotic and thicker epidermis that are assisted with warts [75]. Several studies have evaluated the use of the Nd:YAG laser in the treatment of simple and recalcitrant common, palmoplantar, periungual and subungual warts, with efficacies ranging from 46 to 100% [61,[76][77][78]. Laser protocol varied among different studies: spot size between 3 and 7 mm, pulse duration of 1-20 ms, fluence of 100-200 J/cm 2 , cooling methods, number of pulses between 1 and 8, treatment interval from 2 weeks to 12 months and mean number of treatments between 1.49 and 4.65.…”

“…Aggressive treatment of hand warts may cause tissue damage. To avoid the tissue damage, a novel modification was tried [77]. Fifty one recalcitrant verrucas were treated with ND:YAG laser; all warts were administered in at least three pulses.…”