OK-432 Therapy for Recalcitrant Warts

Twelve patients with warts recalcitrant to various treatments, including cryotherapy, were treated with OK-432 injection therapy. Six patients received only subcutaneous injection, three received only intralesional injection, and the other three received both subcutaneous and intralesional injections. Complete clearing of the warts occurred in nine (75%) of 12 patients, while the other three patients were not cured. Grouping the patients by the method of injection, the success rate of subcutaneous injection was 5/9 (55.6%), and that of intralesional injection was 4/6 (66.7%). Although five patients complained of mild fever and malaise, these side effects gradually disappeared during the repeated injections. OK-432 injection is considered as a hopeful therapy for recalcitrant warts.     

光动力联合二氧化碳激光治疗顽固性跖疣的研究

目的观察外用5-氨基酮戊酸(5-ALA)光动力联合二氧化碳(CO2)激光治疗顽固性跖疣的临床疗效。方法收集顽固性跖疣患者30例,超脉冲CO2激光去除厚硬的角质层,20%5-ALA霜封包4～5 h,633 nm的红光照射20 min(126 J/cm2),用聚合酶链反应技术(polymerase chain reaction,PCR)技术进行人乳头瘤病毒(humanpapillomavirus,HPV)病毒分型,分析各型HPV对光动力治疗反应的差异。结果本组30例患者经3次光动力治疗,16例患者完全缓解(完全缓解率53.3%),4例(13.3%)患者部分缓解,10例(33.3%)患者无反应。各型HPV对光动力治疗的反应差异无统计学意义。结论外用5-ALA光动力联合二氧化碳激光治疗顽固性跖疣是一种新的、有效的、安全的治疗方案,可以作为跖疣的二线治疗方案。     

Treatment of Recalcitrant Viral Warts with Combination Therapy of Systemic Acitretin and Diphenylcyclopropenone Immunotherapy

Viral warts are benign proliferations of the epithelium caused by human papilloma virus (HPV) infection. Diverse therapeutic options are available for viral warts, depending on extension and severity of the disease. We report a case of a 19-year-old man who presented with multiple viral warts on hands and feet for 5 years. He was treated at other clinics before visiting our hospital, but there was no improvement. We treated the lesions with a combination therapy of systemic acitretin and diphenylcyclopropenone (DPCP) immunotherapy for 6 months. A significant improvement was observed during the 12th week of therapy. Herein, we report a case of recalcitrant viral warts showing complete regression when a combination therapy of oral acitretin and immunotherapy was administered.     

The Use of Diphenylcyclopropenone in the Treatment of Recalcitrant Warts

Background: The treatment of recalcitrant palmoplantar and periungual warts using topical immunotherapy with diphenylcyclopropenone (DPC) was reviewed retrospectively over a seven-year period. Methods: Two hundred eleven patients were sensitized during this time. The patients consisted of 90 males and 121 females and were between 5 and 78 years old. Twenty-three patients were lost to followup. Of the remaining, 4 were undergoing treatment at the time of evaluation, 1 patient failed sensitization, and 1 patient became pregnant. Four discontinued because of side effects, 3 because of financial reasons, and 18 patients discontinued treatment prior to completing the minimum required applications (defined as 6), producing a dropout rate of 12% (25/211). Three patients had additional treatment during the course of DPC and were not included in the study. The remaining 154 patients were classified as nonresponders or responders. Results: The responders consisted of 135 individuals (87.7%) that had complete clearance of warts. Reported adverse effects were local and included with pruritus (15.6%), with blistering (7.1%), and with eczematous reactions (14.2%). The majority of the patients tolerated the treatment very well. One patient developed local impetigo. Patients had an average of 5 treatments over a 6-month period. Conclusions: Topical immunotherapy using DPC is an effective treatment option for recalcitrant warts. It should be considered as first-line treatment for warts based on its high response rate, absence of scarring, and painless application.     

方正酸二丁酯外用治疗斑秃疗效观察

目的　观察方正酸二丁酯 (squaricaciddibutylester,SADBE)外用治疗斑秃的临床疗效。 方法　 2 %SADBE丙酮溶液作斑贴试验 ,阳性者给予 0 .0 0 0 0 1%～ 1.0 %的SADBE溶液外用 ,每周 1次。结果　治疗组 16例中 13例 (81.2 5% )长出新发 ,其中 11例 (68.75% )毛发完全再生 ,3例 (18.75% )无新发出现。结论　SADBE局部外用是治疗斑秃的有效方法之一。     

Efficacy and Safety of Topical Cantharidin Treatment for Molluscum Contagiosum and Warts: A Systematic Review

Background and Objective

Topical cantharidin is routinely used for the treatment of molluscum contagiosum and warts. The objective of this systematic review is to assess the efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts.

Methods

We performed a systematic review of studies assessing topical cantharidin treatment of molluscum contagiosum or warts. We searched the databases of Cochrane, EMBASE, GREAT, LILACS, MEDLINE, and Scopus. Two authors performed the study selection and data extraction.

Results

Twenty studies (1958–2018) met inclusion/exclusion criteria. Twelve studies assessed warts, and eight studies assessed molluscum contagiosum. Overall, 1752 patients were included (range 0.3–62 years; specified in 15 studies). Clearance rates with topical cantharidin for molluscum contagiosum were variable (range 15.4–100%). Significant clearance of warts with maintenance of clearance was demonstrated with topical cantharidin alone. Topical cantharidin in combination with podophyllotoxin and salicylic acid demonstrated efficacy for plantar warts (pediatric and adult; clearance rate range 81–100%; four studies had 100% clearance), with the majority clearing after a single treatment. Satisfaction with cantharidin therapy was high, especially in molluscum contagiosum. Pain (7–85.7%), blistering (10–100%), and hyper-/hypopigmentation (1.8–53.3%) were the most commonly occurring adverse effects with cantharidin treatment.

Conclusion

Topical cantharidin demonstrated clearance of warts, particularly in combination with podophyllotixin and salicylic acid, and modest benefit for pediatric molluscum contagiosum with good tolerability and safety.

     

他克莫司软膏治疗儿童特应性皮炎疗效和安全性研究

目的评价0．03％他克莫司软膏治疗儿童中、重度特应性皮炎的疗效和安全性。方法采用多中心．随机、双肓、赋形剂平行对照的临床研究,受试者每日2次外搽0.03％他克莫司软膏或赋形剂,疗程3周,于治疗前及治疗后第1、2、3周各随访1次,进行疗效和安全性评价。结果 5个中心共有139例中、重度儿童特应性皮炎患者纳入疗效分析。治疗结束时,0.03％他克莫司软膏组治疗有效率为84.6％,明显高于赋形剂组的29.0％(P<0．001)。其他疗效评估指标包括湿疹面积与严重度指数、皮损受累面积百分比、症状/体征总评分、研究者对治疗临床反应总评、患者／监护人对瘙痒自我评分。在治疗后第1、2、3周0.03％他克莫司软膏组明显优于赋形剂组,且均于治疗后第1周始即明显改善(P=0.002～P<0．001)。0.03％他克莫司软膏组药物相关不良反应发生率为32.9％,赋形剂组为37.7％,主要表现为皮肤灼热、瘙痒／瘙痒加重或刺痛等局部刺激反应。结论 0.03％他克莫司软膏对治疗儿童特应性皮炎具有良好的疗效和安全性。     

Efficacy of Silver Nitrate Pencils in the Treatment of Common Warts

Common warts are an important issue, especially in children and young adults. The methods proposed for common wart treatment are painful, destructive, and require special experience and devices. The chemical cauterization effect of silver nitrate on warts is noted in the classical pharmaceutical textbooks. In order to test this effect for this purpose, a placebo controlled clinical study was performed on 70 patients. On 35 randomly selected patients, a silver nitrate stick was used, and, on the other 35 patients, black ink was used. At the end of this study, of the patients treated with the silver nitrate stick, 15 (43%) were completely healed, 9 (26%) were partially healed, and 11 (31%) were not healed. Of the patients treated with black ink, 4 (11%) were completely healed, 5 (14%) were partially healed, and 26 (74%) patients were not affected. Thus the silver nitrate stick affected the warts of 24 (69%) patients. Therefore, this method appears to be an effective, economic, and easily applicable treatment for common warts.     

Treatment of Severe Alopecia Areata with Squaric Acid Dibutylester in Pediatric Patients

Abstract: Topical squaric dibutylester (SADBE) is currently used in Europe to treat alopecia areata In adults. We attempted to determine this drug's effectiveness and convenience in treating children with severe aiopecia areata who are psychologically disturbed and resistant to other therapies. Twenty-eight children under 13 years of age who had extensive and Song-standing alopecia areata and were not responsive to conventional therapies were sensitized on the head with 2% SADBE in acetone and treated with weekly applications for 12 months. Nine patients (32.1%) achieved complete or cosmeticaliy acceptable regrowth, and another six (21.4%) had significant regrowth. No correlation was found between response and sex, age of onset of illness, extent, duration, or clinical type of disease. In 14 patients followed for a period ranging from 18 months to 8 years SADBE remained efficacious for reiapses as weSi. This study demonstrates that SADBE is a valid and suitable treatment for children, particuiarly those who are resistant to conventional therapies.     

Management of Warts in Children

The ubiquitous wart plagues us all-patients, parents, atid physicians. Although some of us probably opt for benign neglect, others believe that a temperate or even aggressive approach to therapy is the most appropriate course of action. In this symposium, several practitioners offer their philosophy of therapy as well as specific favored potions and procedures for tackling this problem in chiWren atid adolescents.     

A Pilot Study to Evaluate the Efficacy and Safety of Treatment with Botulinum Toxin in Patients with Recalcitrant and Persistent Erythematotelangiectatic Rosacea

BackgroundThere are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). We previously reported two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injection, and additional research is needed to prove the efficacy and safety of this treatment.ObjectiveTo report the efficacy and safety of botulinum toxin injection as an aid in persistent erythema of rosacea patients.MethodsA total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4, and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the Erythema Index (EI) was assessed by mexameter at each visit. Patient satisfaction and any adverse events were also assessed at each visit.Results17 patients completed all follow-up visits and were included in the analysis. Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of 2.94±0.56 at 8 weeks after treatment. Except for three patients who discontinued the study early due to inconvenience of facial muscle paralysis, 17 patients participating in the final analysis did not report side effects except injection pain at the time of the procedure.ConclusionIntradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.     

ALA-PDT治疗囊肿性痤疮22例疗效观察

目的采用随机对照研究评价3%5-氨基酮戊酸光动力疗法(ALA-PDT)治疗囊肿性痤疮的疗效。方法治疗组22例接受1～3次ALA-PDT,对照组17例口服异维A酸胶丸20mg/d。皮损消退>90%或治疗持续6周为研究终点。结果治疗组第2,4,6周囊肿数目较对照组明显减少(P<0.01);治疗组第2,4,6周有效率分别为9.09%,40.91%,100%,而对照组分别为0,11.76%,58.82%,差异有统计学意义(P均<0.05);B超显示ALA-PDT治疗后囊肿较治疗前缩小或消失(P<0.01)。研究结束时,治疗组患者满意度较对照组高(P<0.05);治疗组复发率较对照组明显降低(P<0.05),且首次复发时间较对照组延长(P<0.05)。结论 ALA-PDT能够安全快速治愈囊肿性痤疮,同时延迟复发。     

Treatment of Extensive Warts with Etretinate: A Clinical Trial in 20 Children

To evaluate the clinical-effectiveness of etretinate in the treatment of papilloma virus infections, 20 children with extensive warts were given this oral retinoid for a period not exceeding three months at a dosage of 1 mg per kg per day. Sixteen patients showed complete regression of the disease without relapse, while in 4, lesions recurred after partial regression had been obtained. A follow-up of two years confirmed these findings. The results of this preliminary study are encouraging. Additional study is needed to determine the ultimate usefulness of etretinate in the treatment of refractory warts.     

调Q Nd:YAG激光联合局部用药治疗扁平疣疗效观察

目的观察调Q Nd:YAG激光联合维A酸乳膏和重组人干扰素α-2b凝胶治疗扁平疣的疗效。方法将70例扁平疣患者随机分为两组,实际完成疗程67例,A组34例,B组33例,两组均予调Q Nd:YAG激光532nm波长治疗1～4次,每次间隔2周。A组采用调Q Nd:YAG激光治疗痂脱落后外用0.1%维A酸乳膏,每晚1次;白天外用重组人干扰素α-2b凝胶,4次/d,共4周。B组单采用调Q Nd:YAG激光治疗。结果 A组治愈率(94.12%)、有效率(97.06%)、复发率(6.25%)与B组治愈率(69.70%)、有效率(75.76%)、复发率(30.43%)相比,差异均有统计学意义(P均<0.05)。结论调QNd:YAG激光联合维A酸乳膏和重组人干扰素α-2b凝胶治疗扁平疣安全性高,治愈率高,复发率低。     

5-氨基酮戊酸光动力三阶段治疗尖锐湿疣疗效分析

目的评价5-氨基酮戊酸光动力联合其他疗法三阶段治疗尖锐湿疣的疗效。方法采用前期处理、光动力治疗、后期处理三阶段治疗尖锐湿疣230例,光动力治疗1～10次,每周一次,末次治疗后4月～2年半判断疗效并观察复发率。结果三阶段总治愈率89.00%,复发率5.50%。在治愈的病人中,1次和2次治愈的病例之和达52.00%。结论对于尖锐湿疣可以常规采用2次光动力治疗,可以明显减少复发。     

中药药浴联合他克莫司软膏治疗儿童特应性皮炎的疗效及安全性观察

目的 评价中药药浴联合他克莫司软膏外用治疗儿童特应性皮炎的临床疗效及安全性.方法 本试验采用随机、单盲、阳性平行对照试验将45例儿童患者采用随机数字表分成治疗组和对照组.治疗组23例,对照组22例.治疗组采用中药药浴治疗联合外用0.03％他克莫司软膏外用,1次/d.对照组单用0.03％他克莫司软膏外用,1次/d,疗程均为4周.随访3个月.结果 4周疗程结束后,2组间有效率差异无统计学意义(x2=5.148,P＜0.05).2组初诊时SCORAD积分值比较差异无统计学意义(t=0.557,P＞0.05),治疗4周后SCORAD积分值比较差异具有统计学意义(x2=5.148,P＜0.05)).结论 中药药浴联合0.03％他克莫司软膏较单用0.03％他克莫司软膏治疗特应性皮炎疗效较优,复发率低,安全性好,值得临床推广.     

阿维A治疗68例儿童重症银屑病的疗效及安全性分析

目的观察阿维A治疗儿童重症银屑病的临床疗效和安全性。方法选择临床上诊断明确的重症儿童银屑病68例,其中寻常性55例(PASI评分≥10),脓疱型9例,关节病型3例,红皮病型1例。按0.5～1.0mg/(kg·d)顿服阿维A,治疗后观察临床疗效和不良反应,包括治疗前后检测肝肾功能、血脂及对儿童生长发育的影响等。结果治疗12周后痊愈41例,显效16例,有效率83.82%。临床最常见不良反应是干燥型唇炎,占100%(68例),其次为皮肤瘙痒30.00%(21例),皮肤脆性增加占26.00%(18例)。治疗前后查肝功能、肾功能和血脂均未见异常,患儿的身高和体重也无明显变化。结论阿维A治疗儿童重症银屑病疗效肯定,耐受性好,但要严格控制其适应症。     

5-氨基酮戊酸光动力疗法治疗尿道口尖锐湿疣疗效观察

目的观察5-氨基酮戊酸光动力疗法（ALA-PDT）治疗尿道口尖锐湿疣（CA）的临床疗效和安全性。方法 60例尿道口尖锐湿疣患者随机分为实验组和对照组各30例,实验组采用5-氨基酮戊酸光动力疗法治疗,每周1次,连续3次;对照组用CO2激光治疗,外涂百多邦软膏,每周复查1次,连续3次,治疗结束后第4,8,12周评估疗效。结果治疗组痊愈率93.3%（28/30）,复发率10.7%（3/28）,不良反应为光照时疼痛,术后出现轻度红肿、排尿痛;对照组治愈率100%,复发率43.3%（13/30）,不良反应为术中出血、术后疼痛、局部感染、溃疡及瘢痕形成。实验组复发率（10.7%）显著低于对照组（43.3%）（P〈0.01）。结论 5-氨基酮戊酸光动力疗法治疗尿道口尖锐湿疣疗效好,复发率低,局部不良反应轻,安全性高。