Carbon dioxide laser management of plantar verruca: a 6-year follow-up survey

Patients receiving treatment for plantar verruca by carbon dioxide laser vaporization from 1984 through 1989 were surveyed with follow-up from 3 months to 6 years. Materials and methods, operative technique, and results were reviewed. This procedure was used as both a primary treatment as well as secondary or tertiary treatments on recalcitrant verrucae. Solitary as well as multiple or mosaic lesions were evaluated. Patients were surveyed for elimination of all verrucae, partial or complete recurrence, postoperative complications, and satisfaction. The overall success rate, considering all eight treatment categories, was 75%. Ultimate success rates ranged from 93% for solitary lesions to 62% for multiple recalcitrant lesions. The authors' findings show clinical significance in the marked differentiation of success rates in accordance with the classification scheme. That is to say, initial treatment of a solitary lesion showed a higher success rate than initial treatment of multiple lesions, and initial treatment of virgin lesions showed a higher success rate than initial treatment of recalcitrant lesions. Based on the data accumulated, the authors propose that treatment of plantar verruca be initiated early, i.e., while the lesion is solitary and has been heretofore untreated. On the other hand, those lesions having a second or third treatment by carbon dioxide laser vaporization resulted in a higher ultimate success rate than those which had only one primary treatment. The general conclusion is that carbon dioxide laser management should be considered as a viable treatment alternative in relation to other, more traditional, techniques in the treatment of plantar verruca.