Cryosurgery treatment of plantar warts

Abstract

Plantar warts are common, painful and contagious. Because of their dept of penetration, self treatment with topical creams and gels is often very slow and commonly unsuccessful. Surgical excision or cautery are very painful, can leave permanent tender scars and often lead to relapse because of the Koebner phenomenon. 100 consecutive patients with plantar warts treated by one General Practitioner over a sixteen month period were analysed. Patients were followed up to assess success and relapse rates and the development of any complications. The number, type, size and position of plantar warts were also recorded and analysed. A total of 514 plantar warts presented for treatment. 505 Plantar Warts in 96 patients were considered suitable for treatment using liquid nitrogen cryosurgery via a Byrmill cryogun. Patients were treated by the open spray technique after debulking the plantar wart using a surgical blade. 421 plantar warts (83.5%) cleared completely with one single treatment of cryosurgery. A further 30 (6%) cleared with two treatments and another 15 (3%) cleared with three treatments. In total, 467 plantar warts (92.5%) cleared completely using cryosurgery and 90% of these cleared with one treatment. Of the remaining 38 plantar warts, 23 (4.5%) were lost to follow up and 12 (2.4%) were managed using other techniques after initially being treated with cryosurgery. Only 3 (0.6%) plantar warts failed to clear. However, all three were smaller and less painful after treatment. No patient had to be referred to hospital for treatment of their plantar warts. There were no serious complications of treatment. This study highlights the advantages of cryosurgery for treating plantar warts in general practice. This technique is quick, safe, highly successful, has a low relapse rate and leaves little or no scars.