Warts (non-genital)

Overview

Abstract | Cite as | Substantive changes

Abstract

INTRODUCTION: Warts are caused by the human papillomavirus (HPV), of which there are over 100 types. HPV probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; intralesional candida antigen; contact immunotherapy; cryotherapy; duct tape occlusion; photodynamic treatment; pulsed dye laser; surgical procedures; and topical salicylic acid.

Cite as

Loo SK and Tang WY. Warts (non-genital). Clinical Evidence 2014; 06:.

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Substantive changes

Topical salicylic acid One systematic review updated.[9] Categorisation unchanged (beneficial).

Contact immunotherapy (dinitrochlorobenzene) One systematic review updated.[9] Categorisation unchanged (likely to be beneficial).

Cryotherapy One systematic review updated,[9] and one subsequent RCT added.[12] Categorisation unchanged (likely to be beneficial).

Photodynamic treatment One systematic review updated,[9] and one subsequent RCT added.[12] Categorisation changed from likely to be beneficial to unknown effectiveness.

Intralesional bleomycin One systematic review updated.[9] Categorisation unchanged (unknown effectiveness).

Candida antigen (intralesional) New option. Categorised as unknown effectiveness.

Duct tape occlusion One systematic review updated.[9] Categorisation unchanged (unknown effectiveness).

Latest guidelines

Latest citations

Local hyperthermia at 44 degrees C for the treatment of plantar warts: a randomized, patient-blinded, placebo-controlled trial. ( 20 October 2014 )

EVerT: cryotherapy versus salicylic acid for the treatment of verrucae - a randomised controlled trial. ( 20 October 2014 )