Treatment of cutaneous viral warts in children: A review

Abstract

Viral warts or verruca are very common skin infections in children. Although benign, lesions can be extensive, painful, bleed, or lead to cosmetic disfigurement. Although spontaneous resolution can occur, parents often bring their children for treatment, especially when they are symptomatic. Many publications have assessed the efficacy and safety of treatment of warts in adults. However, treatment in children can be challenging due to their immune responses and lower threshold for pain. We review the current literature on the methods, efficacy, and side effect profile of common treatment modalities for cutaneous viral warts in children. There is evidence that salicylic acid and cryotherapy are effective, and although cryotherapy is more effective, there is a higher risk of side effects such as pain and blistering. Combination treatment with salicylic acid and cryotherapy may reduce these side effects. Although there is limited data, other treatment options such as cantharidin, immunotherapy and other mechanical therapies, for example, carbon dioxide lasers, may also be considered, especially for recalcitrant lesions.

Aspects of Antiviral Strategies Based on Different Phototherapy Approaches: Hit by the Light

“…Most common viruses that cause skin conditions include Poxiviridae , Paramyxoviridae , Papilomaviridae and Herpesviridae families. Symptoms [ 111 ] can vary from rough bumps on the skin [ 112 , 113 , 114 ] to pain, numbness, or a tingling sensation in the affected area [ 115 ]. Viral skin infections are more common in children and immunocompromised patients, and one of the most prevalent ones are HPV-caused verrucae.…”

“…Dimethyl ether and propane are more accessible, but their efficacy is significantly lower than the one from liquid nitrogen [ 113 ]. Generally, cryotherapy is not recommended for younger patients, as it has been commonly associated with pain and discomfort [ 113 , 114 ]. Warts can also be treated with salicylic acid [ 117 ], a natural plant extract with anti-inflammatory and antibacterial properties [ 113 ].…”

“…Moreover, it is not recommended to patients suffering from nerve damage or arterial narrowing [ 113 ]. Some other, less effective topical methods include treatment with formaldehyde, glutaraldehyde, and silver nitrate among others [ 111 , 114 , 116 ]. All mentioned therapies are widely used, but neither is suitable for treating resistant plantar warts [ 113 , 117 ].…”

Verrugas plantares: caminando hacia la adherencia

“…El 30 % desaparecen en 6 meses, y el 40 %, a los 2 años. Pero esta opción puede tardar más -sobre todo, en inmunodeprimidos y en lesiones de larga evolución-y, mientras existe la verruga plantar, persisten la morbilidad, el dolor, la repercusión estética [7][8][9] , la mala calidad de vida y el riesgo de contagio. Por ello, la opción que se debe elegir es la de tratar.…”

Serum level of interleukin‐22 in patients with cutaneous warts: A case‐control study

“…Warts are viral cutaneous infections caused by human papilloma virus (HPV), presented by verrucous growth over the skin surface 1 . Its histopathological features entail keratinocyte hypercornification 2 .…”