Ahsan Anwar, Kehkshan Tahir, Muhammad Shahid, Shahbaz Aman, Zaib.
Comparison of efficacy of ablative CO2 laser vs. liquid nitrogen cryotherapy in the treatment of palmoplantar warts.
J Pak Assoc Derma Jan ;31(3):366-72.

Background: Viral warts are benign epidermal proliferations caused by Human Papilloma Viruses (HPVs). Various treatment modalities have been described for viral warts, all of these are associated with advantages and disadvantages. The appropriate treatment modality depends on the number, size, and location of the lesions in addition to patient's immunologic status.Methods: A total of 120 patients (60 patients in each group), fulfilling inclusion and exclusion criteria, were enrolled in the study. Group A was treated with ablative CO2 Laser continuous wave (CW) mode (4-6 watts) per lesion per week up to clearing or maximum of 8 weeks. In Group B patients were treated with liquid nitrogen cryotherapy (-196 oC) using cryospray method. Two freeze – thaw cycle method was applied once a week until clearing of all lesions or till maximum of 8 weeks. The data was recorded in terms of reduction of number, size or complete disappearance of warts and considered cleared if not visible to naked eye.Results: Mean age of patients in group A was 32.0±10.99 and in group B was 31.63±10.64 years. Efficacy was seen in 53 (86.33 %) patients in group A and 36 (60 %) patients in group B. Statistically significant difference in efficacy was found in ablative CO2 Laser group as compared with liquid nitrogen cryotherapy (p=0.0004).Conclusion: The results of this study reveal that ablative CO2 Laser is more efficacious than liquid nitrogen cryotherapy in treating palmoplantar warts in terms of complete clearance.Keywords: Palmoplantar warts, ablative CO2 Laser, liquid nitrogen cryotherapy.

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