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      Successful Treatment of Multiple Plantar and Periungual Warts by Local Hyperthermia Treatment: A Case Report

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          Abstract

          Local hyperthermia treatment, a common immunoadjuvant therapy, has been used in treating various human papillomavirus (HPV) infections. For multiple warts, it can clear off all warts of the body through targeted irradiation on one wart. We reported a case of a 22-year-old patient with multiple plantar warts combined with periungual warts, in which previous treatments were ineffective. Therefore, we utilized local hyperthermia treatment at 44°C using the largest fused-wart plaque on the right plantar as the treatment target for 30-minute irradiation each time. The hyperthermia induction therapy was performed on day 1, 2, 3, 12 and 13, followed by weekly maintenance therapy for 6 times. After 2 months of treatment, both irradiated and non-irradiated lesions disappeared, and no recurrence occurred during the follow-up period. This case indicates that local hyperthermia treatment may be a safe and effective approach for patients with multiple, recalcitrant, and site-specific viral warts due to the ineffectiveness of conventional treatment.

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          Advancements in Pharmacotherapy for Noncancerous Manifestations of HPV

          Ramya Kollipara, Erfon Ekhlassi, Christopher Downing … (2015)
          Human papillomavirus (HPV) is the most common sexually transmitted disease. Via infection of the basal epithelial cells, HPV causes numerous malignancies and noncancerous cutaneous manifestations. Noncancerous cutaneous manifestations of HPV, including common, plantar, plane, and anogenital warts, are among the most common reasons for an office visit. Although there are various therapies available, they are notoriously difficult to treat. HPV treatments can be grouped into destructive (cantharidin, salicylic acid), virucidal (cidofovir, interferon-α), antimitotic (bleomycin, podophyllotoxin, 5-fluorouracil), immunotherapy (Candida antigen, contact allergen immunotherapy, imiquimod) or miscellaneous (trichloroacetic acid, polyphenon E). The mechanism of action, recent efficacy data, safety profile and recommended regimen for each of these treatment modalities is discussed.
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            Topical treatment for plantar warts: A systematic review.

            Sara García‐Oreja, Francisco Javier Álvaro-Afonso, Yolanda García-Álvarez … (2021)
            There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the efficacy of different topical treatments on plantar warts. Systematic electronic searches (Pubmed, Cochrane Library, Embase, and Web of Science) were conducted in April 2020. Meta-analyses, systematic reviews, and retrospective or prospective clinical trials of the effects of topical and nonsurgical treatments of plantar warts were included. Two authors performed the study selection and data extraction. Any discrepancies between the two reviewers were discussed with a third reviewer. Forty-four studies were included. The average cure rates of the most frequent treatments were variable across the studies: cryotherapy (45.61%), salicylic acid (13.6%), cantharidin-podophyllin-salicylic acid formulation (97.82%), laser (79.36%), topical antivirals (72.45%), intralesional bleomycin (83.37%), and intralesional immunotherapy (68.14%). Twenty-two studies (50%) had a level of evidence 1b and grade of recommendation A, five studies (11.4%) had a level of evidence 2b and grade of recommendation B, two studies (4.5%) had a level of evidence 3b and grade of recommendation B, and 15 studies (34,1%) with a level of evidence 4 and grade of recommendation C. First-choice treatments for common warts, such as cryotherapy and salicylic acid, have low-cure rates for plantar warts. Other treatments, such as CPA formulation, immunotherapy, and intralesional bleomycin, which have compassionate use, have higher cure rates. This review should stimulate future high-quality research to evaluate these specialized treatments.
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              Hyperthermia on skin immune system and its application in the treatment of human papillomavirus-infected skin diseases.

              Xinghua Gao, Hongduo Chen (2014)
              Hyperthermia is a condition characterized by increased body temperature as a consequence of failed thermoregulation. Hyperthermia occurs when a body produces or absorbs more heat than it dissipates. Hyperthermia also elicits various effects on the physiology of living cells. For instance, fever-range temperature (39°C to 40°C) can modulate the activities of immune cells, including antigen-presenting cells, Tcells, and natural killer cells. Heat shock temperature (41°C to 43°C) can increase the immunogenicity of tumor cells. Cytotoxic temperature (> 43°C) can create an antigen source to induce an anti-tumor immune response. The immunomodulatory effect of hyperthermia has promoted an interest in hyperthermia-aided immunotherapy, particularly against tumors. Hyperthermia has also been used to treat deep fungal, bacterial, and viral skin infections. We conducted a series of open or controlled trials to treat skin human papillomavirus infection by inducing local hyperthermia. More than half of the patients were significantly cured compared with those in the control trial. A series of challenging clinical cases, such as large lesions in pregnant patients or patients with diabetes mellitus, were also successfully and safely managed using the proposed method. However, further studies should be conducted to clarify the underlying mechanisms and promote the clinical applications of hyperthermia.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Cosmet Investig Dermatol
                Journal ID (iso-abbrev): Clin Cosmet Investig Dermatol
                Journal ID (publisher-id): ccid
                Title: Clinical, Cosmetic and Investigational Dermatology
                Publisher: Dove
                ISSN (Electronic): 1178-7015
                Publication date (Electronic): 07 April 2023
                Publication date Collection: 2023
                Volume: 16
                Pages: 981-985
                Affiliations
                [1 ]Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure , Huzhou City, Zhejiang Province, 313200, People’s Republic of China
                Author notes
                Correspondence: Huiliang Shen, Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure , No. 61, Wuyuan Street, Wukang Town, Deqing County, Huzhou City, Zhejiang Province, 313200, People’s Republic of China, Email shl.1168@163.com
                Author information
                http://orcid.org/0000-0002-6704-9103
                Article
                Publisher ID: 408406
                DOI: 10.2147/CCID.S408406
                PMC ID: 10089273
                SO-VID: f87e42f7-e331-4230-ad3c-9c7473b92050
                Copyright © © 2023 Wang et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 14 February 2023
                Date accepted : 31 March 2023
                Page count
                Figures: 2, References: 12, Pages: 5
                Funding
                Funded by: Zhejiang Medical and Health Science and Technology Plan: 2023KY656;
                Research reported in this publication was supported by Zhejiang Medical and Health Science and Technology Plan: 2023KY656.
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Dermatology
                Keywords: local hyperthermia treatment,multiple,plantar warts,periungual warts
                Data availability:
                ScienceOpen disciplines: Dermatology
                Keywords: local hyperthermia treatment, multiple, plantar warts, periungual warts

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