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Published on: November 6, 2019
Successful treatment of recalcitrant warts in pediatric patients with carbon dioxide laser
Insights
This study shows a modified carbon dioxide (CO2) laser technique effectively treats stubborn warts in children. The procedure demonstrated a high success rate with minimal side effects, offering a promising solution for pediatric wart removal.
Area of Science:
- Dermatology
- Pediatric Surgery
- Laser Medicine
Background:
- Warts are common skin infections, particularly in children.
- Recalcitrant warts often resist conventional treatments like caustic agents and surgery.
- Effective and safe treatment options for pediatric warts are needed.
Purpose of the Study:
- To evaluate the efficacy and safety of a modified carbon dioxide (CO2) laser technique for treating recalcitrant warts in pediatric patients.
- To assess the recurrence rates and side effects associated with this laser procedure.
Main Methods:
- A cohort of 40 pediatric patients with 54 recalcitrant warts underwent treatment with a modified CO2 laser.
- The technique involved precise excision and vaporization of wart tissue.
- Procedures were performed under local or digital block anesthesia, with sedation in two cases.
Main Results:
- No recurrence of warts was observed at the 12-month follow-up.
- The treatment showed a high success rate with minimal complications, including no intractable bleeding or infection.
- Healing time averaged 4 to 5 weeks, with minor hypopigmentation noted in 27.5% of cases.
Conclusions:
- The modified CO2 laser technique is a highly effective treatment for recalcitrant warts in children.
- This method offers a favorable safety profile and is well-tolerated by young patients.
- The technique presents a viable alternative for managing difficult-to-treat pediatric warts.
Aim:
Warts are difficult to treat and none of the several modes of treatment suggested for their cure has been proven to be the most effective. We evaluated the efficacy of a modification of the CO (2) laser technique for recalcitrant warts in pediatric patients.
Patients And Methods:
During a period of 5 years, 40 consecutive pediatric patients (average age: 12.7 +/- 2.8 years) were treated by CO (2) laser for 54 recalcitrant warts. Previous treatments were caustic and/or surgical procedures (average 2.7 procedures). Local anesthesia or digital block was performed in all patients, with intravenous sedation in two patients. The laser was used at 5 W in super-pulse mode throughout the procedure. The skin was cut with the focused laser beam in a circular fashion, about 5 mm around the wart, until all the layers of the skin down to the subcutaneous tissue were penetrated. The lesion was drawn aside and excised, using the laser beam as a scalpel. No curettage was used. The base of the wart was then vaporized with the laser in a defocused fashion, until a clean surgical field was obtained. Follow-up was weekly up to 1 month, and at 3, 6, and 12 months.
Results:
Warts were located on fingers (24 cases), in the plantar area (10 cases), on hands (9 cases), knees, and legs (4 cases each), arms (2 cases) and elbow (1 case). Twenty-seven patients (67.5 %) had a solitary wart and the other 13 children had multiple warts (up to 6) at one or more locations. Fingers were the most common location of multiple warts (10 cases). All patients underwent the procedure in one session. No case of intractable operative bleeding, local infection, or prolonged exudative drainage was encountered. One patient complained of severe transient postoperative pain. The healing time was 4 to 5 weeks. At 12 months, there was no recurrence of the warts. No significant or disabling scarring was noticed, but hypopigmentation was noted in 11 cases (27.5 %).
Conclusion:
This technique provides a high success rate with minimal side effects and is well tolerated by young patients.
