TITLE

Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trial

AUTHOR(S)
Bruggink, Sjoerd C.; Gussekloo, Jacobijn; Berger, Marjolein Y.; Zaaijer, Krista; Assendelft, Willem J. J.; de Waal, Margot W. M.; Bouwes Bavinck, Jan Nico; Koes, Bart W.; Eekhof, Just A. H.
PUB. DATE
October 2010
SOURCE
CMAJ: Canadian Medical Association Journal;10/19/2010, Vol. 182 Issue 15, p1624
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Cryotherapy is widely used for the treatment of cutaneous warts in primary care. However, evidence favours salicylic acid application. We compared the effectiveness of these treatments as well as a wait-and-see approach. Methods: Consecutive patients with new cutaneous warts were recruited in 30 primary care practices in the Netherlands between May 1, 2006, and Jan. 26, 2007. We randomly allocated eligible patients to one of three groups: cryotherapy with liquid nitrogen every two weeks, self-application of salicylic acid daily or a wait-and-see approach. The primary outcome was the proportion of participants whose warts were all cured at 13 weeks. Analysis was on an intention-to-treat basis. Secondary outcomes included treatment adherence, side effects and treatment satisfaction. Research nurses assessed outcomes during home visits at 4, 13 and 26 weeks. Results: Of the 250 participants (age 4 to 79 years), 240 were included in the analysis at 13 weeks (loss to follow-up 4%). Cure rates were 39% (95% confidence interval [CI] 29%-51%) in the cryotherapy group, 24% (95% CI 16%-35%) in the salicylic acid group and 16% (95% CI 9.5%-25%) in the wait-and-see group. Differences in effectiveness were most pronounced among participants with common warts (n = 116): cure rates were 49% (95% CI 34%-64%) in the cryotherapy group, 15% (95% CI 7%-30%) in the salicylic acid group and 8% (95% CI 3%-21%) in the wait-and-see group. Cure rates among the participants with plantar warts (n = 124) did not differ significantly between treatment groups. Interpretation: For common warts, cryotherapy was the most effective therapy in primary care. For plantar warts, we found no clinically relevant difference in effectiveness between cryotherapy, topical application of salicylic acid or a wait-and-see approach after 13 weeks. (ClinicalTrial.gov registration no. ISRCTN42730629)
ACCESSION #
54722817

 

Related Articles

  • Treatment of Nongenital Warts. Goodheart, Herbert P. // Women's Health in Primary Care;Feb2007, Vol. 10 Issue 2, p11 

    The article focuses on the treatment of nongenital warts. It cites several factors on which the method of treatment depends such as the patient's age, type of wart and location of the lesion. It highlights the advantages of using salicylic acid in treating warts. The objective in using...

  • The EVERT (effective verruca treatments) trial protocol: a randomised controlled trial to evaluate cryotherapy versus salicylic acid for the treatment of verrucae. Cockayne, E. Sarah // Trials;2010, Vol. 11, p12 

    Background: Verrucae are a common, infectious and sometimes painful problem. The optimal treatment for verrucae is unclear due to a lack of high quality randomised controlled trials. The primary objective of this study is to compare the clinical effectiveness of two common treatments for...

  • Cost-effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts: economic evaluation alongside a randomised controlled trial (EVerT trial).  // Journal of Foot & Ankle Research;2012, Vol. 5 Issue 1, p4 

    The article presents a study which describes the cost-effectiveness analysis, conducted alongside a pragmatic multicentre, randomized trial evaluating the clinical effectiveness of cryotherapy versus 50 percent salicylic acid of the treatment of plantar warts. As mentioned, cryotherapy was found...

  • Cutaneous Warts: An Evidence-Based Approach to Therapy. Bacelieri, Rocky; Johnson, Sandra Marchese // American Family Physician;8/15/2005, Vol. 72 Issue 4, p647 

    Cutaneous warts are a common presenting complaint in children and adolescents. Common, plantar, or flat warts are cutaneous manifestations of the human papillomavirus. The treatment of warts poses a therapeutic challenge for physicians. No single therapy has been proven effective at achieving...

  • Freezing is best option for warts.  // GP: General Practitioner;9/17/2010, p14 

    The article focuses on a study published in "Canadian Medical Association Journal" (CMAJ) on the benefits of cryotherapy in removing common warts. In the study, conducted by researchers in the Netherlands, effectiveness of three treatments were analyzed on 240 participants. Cryotherapy cured...

  • Local treatments for cutaneous warts: systematic review. Gibbs, Sam; Harvey, Ian; Sterling, Jane; Stark, Rosemary // BMJ: British Medical Journal (International Edition);8/31/2002, Vol. 325 Issue 7362, p461 

    Abstract Objective: To assess the evidence for the efficacy of local treatments for cutaneous warts. Methods: Systematic review of randomised controlled trials. Main outcomes measures: Total clearance of warts and adverse effects such as irritation, pain, and blistering. Study selection:...

  • La crioterapia en Atención Primaria.  // AMF: Actualización en Medicina de Familia;2011, Vol. 7 Issue 7, p391 

    No abstract available.

  • Cryosurgical Treatment of Periungual Warts. Kuflik, Emanuel C. // Journal of Dermatologic Surgery & Oncology;Sep84, Vol. 10 Issue 9, p673 

    Verrucae commonly occur at the periungual areas and pose a problem in management. They can be small or large and may develop on more than one finger. Periungual warts can extend beneath or around the nail, causing discomfort and an embarrassingly poor cosmetic appearance. Successful treatment...

  • PAINFUL BLISTERING AFTER CRYOTHERAPY. Wyndham, Mike // Pulse;4/30/2008, Vol. 68 Issue 15, p39 

    The article presents a case of a young man who received a cryotherapy treatment in a minor surgery clinic for warts. He had a couple of blasts of liquid nitrogen to the affected areas and topped with a standard anti-wart treatment. After a couple of days, the treatment resulted to a painful...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics