Abstract
Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the diverse number of treatments available. Therapies targeting vasculature, such as pulsed dye laser, have been used successfully in the treatment of plantar warts. Polidocanol, a detergent sclerosant approved for the sclerotherapy of incompetent and dilated saphenous veins, has also been used as an off-label therapy for a wide range of skin conditions with vascular components such as hemangiomas and pyogenic granuloma. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional polidocanol 3% in the treatment of plantar warts. Twenty patients (11 females and 9 males), with plantar warts, aged 12–50 years received biweekly sessions of intralesional polidocanol 3% until complete clearance or for a maximum of 6 sessions. Response to treatment was graded as complete (100% clearance), partial (50–99%), and no response (< 50%). At the end of the study, 12 (60%) patients achieved complete clearance of their warts after 1–5 sessions, 5 (25%) patients had only partial response, and 3 (15%) patients did not achieve any clearance of their warts. The procedure was largely tolerable by patients. Pain at the injection site and bruises were reported by 9 (45%) and 2 (10%) patients, respectively. Both side effects resolved spontaneously and completely within a few days. The findings of the current study suggest that intralesional injection of 3% polidocanol in biweekly sessions may be a safe, effective, and tolerable method for the treatment of plantar warts.
Data availability
No datasets were generated or analysed during the current study.
References
Borovoy M, Borovoy M, Elson L, Sage M (1996) Flashlamp pulsed dye laser (585 nm). Treatment of resistant verrucae. J Am Podiatr Med Assoc 86:547–550
El-Mohamady Ael S, Mearag I, El-Khalawany M, Elshahed A, Shokeir H, Mahmoud A (2014) Pulsed dye laser versus nd:YAG laser in the treatment of plantar warts: a comparative study. Lasers Med Sci 29:1111–1116. https://doi.org/10.1007/s10103-013-1479-y
Elder DE (2014) Lever’s histopathology of the skin. Lippincott Williams & Wilkins, City
García-Oreja S, Álvaro-Afonso FJ, García-Madrid M, López-Moral M, García-Álvarez Y, Lázaro-Martínez JL (2023) Cryotherapy versus topical nitric-zinc complex solution for the treatment of plantar warts: a randomized controlled trial. J Med Virol 95:e29212. https://doi.org/10.1002/jmv.29212
Hekmatjah J, Farshchian M, Grant-Kels JM, Mehregan D (2021) The status of treatment for plantar warts in 2021: no definitive advancements in decades for a common dermatology disease. Clin Dermatol 39:688–694. https://doi.org/10.1016/j.clindermatol.2021.05.024
Ibrahim SMA, Soliman M, Mohamed SKA, Soliman MM (2021) Pulsed dye laser versus nd:YAG laser in the treatment of recalcitrant plantar warts: an intraindividual comparative study. J Cosmet Laser Ther 23:130–136. https://doi.org/10.1080/14764172.2021.2016843
Khunger N, Sacchidanand S (2011) Standard guidelines for care: sclerotherapy in dermatology. Indian J Dermatol Venereol Leprol 77:222–231. https://doi.org/10.4103/0378-6323.77478
Khurana A, Mathachan SR (2022) Polidocanol Sclerotherapy in Pyogenic Granulomas. Dermatol Surg 48:72–75. https://doi.org/10.1097/dss.0000000000003308
Nguyen QD, Stender C, Bur D, Silapunt S (2022) Polidocanol: a review of off-label dermatologic uses. Dermatol Surg 48:961–966. https://doi.org/10.1097/dss.0000000000003520
Parsi K (2015) Interaction of detergent sclerosants with cell membranes. Phlebology 30:306–315 Doi 10.1177/0268355514534648
Wang H, **ong L, **a Y, Wang X (2020) 5-aminolaevulinic acid-based photodynamic therapy induces both necrosis and apoptosis of keratinocytes in plantar warts. J Cosmet Laser Ther 22:165–170. https://doi.org/10.1080/14764172.2020.1785626
Yiannakopoulou E (2016) Safety concerns for Sclerotherapy of Telangiectases, reticular and varicose veins. Pharmacology 98:62–69. https://doi.org/10.1159/000445436
Zhu P, Qi RQ, Yang Y, Huo W, Zhang Y, He L, Wang G, Xu J, Zhang F, Yang R al (2022) Clinical guideline for the diagnosis and treatment of cutaneous warts (2022). J Evid Based Med 15:284–301. https://doi.org/10.1111/jebm.12494
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All authors contributed to the study conception and design. A. K. wrote the first draft of the manuscript. All authors read and approved the final manuscript.
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Eassa, B.I., Abdel-Hameed, A.K.S. & Ismail, A.I.A. Safety and efficacy of intralesional polidocanol sclerotherapy in the treatment of plantar warts: a pilot study. Arch Dermatol Res 316, 204 (2024). https://doi.org/10.1007/s00403-024-02939-9
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DOI: https://doi.org/10.1007/s00403-024-02939-9