Predictive dermoscopic features of cryotherapy treatment response in cutaneous warts

The utility of dermoscopy for the diagnosis of cutaneous warts is well known. However, its role in predicting the outcome of cryotherapy for cutaneous warts remains unexplored. To identify dermoscopic features predicting treatment responses in cryotherapy for cutaneous warts. We conducted a retrospective analysis of 119 warts in 103 patients. Responses were categorized as complete, partial, or none after three sessions of cryotherapy within 4 months. The evaluated features included vascularity, papillary patterns, and margin characteristics. Marked surface scales and well-defined margins were common in complete responses. Minimal surface scales and smooth patterns were observed in less responsive cases. In the group with a complete response, marked surface scales were observed 6.59 times more frequently, well-defined margins were 4.1 times more common, and dots were 4.07 times more common compared to the group with no response. Common warts responded well when showing vascularity and marked surface scales, whereas plantar warts responded positively when showing background erythema. Dermoscopic features, such as dots, marked surface scales, and well-defined margins, predict a favorable cryotherapy response in cutaneous warts. Plantar warts respond positively in the presence of perilesional erythema, whereas common warts exhibit vascularity and marked surface scales for a better response to cryotherapy.