Page 106 - LECTURE NOTES

Treatment is aimed as long as possible without scarring, since no treatment can

guarantee or prevent recurrence. In immune-compromised patients the goal is probably
even more modest, ie to control the size and number of lesions present.

A- Removal of wart
1. Cry therapy like liquid nitrogen – applied for 5-10 seconds every 2-4 weeks –

scarring will occur if it is used incorrectly, or too aggressively. Improper use
along the side of the fingers has been reported to cause nerve damage. The

treatment also causes permanent depigmentation in darkly pigmented

individual
2. Keratolytic agent

Warts may be treated by applying a 40% salicylic acid plaster .The plaster may

be left on, for 5-6 days, for weeks or months, to eradicate the wart; the method
is safe and effective with almost no side effects

3. 25% podophyllum resin in compound tincture of benzene or alchol applied
weekly on anogenital wart, the treatment is not used for pregnant mothers

4. Operative removal, plantar warts may be removed by blunt dissection.
Electrocautery may be used for excision of warts, however, this may result in a

permanent painful scar on the foot

5. Other agents – bleomycin diluted to 0.1% with 0.9% saline may be injected
under warts, not exceeding 0.1 ml per puncture. It is useful for plantar and

common warts
a. Retinoids Tretinoin (Retin – A) cream or gel applied topically twice daily may

be effective for facial or beard area warts
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b. Physical modalities soaking warts in hot (42.2 c) water for 10-30 minutes
daily, for 6 weeks.

4.5.4 Herpes Simplex

Herpes simplex is a viral infectious disease of humans. Herpes simplex is caused

by herpes viruses, which are clinically indistinguishable, known as herpes virus
type 1 and herpes virus type 2. Herpes virus type 1 is mainly responsible for

herpes labialis while type 2 is usually associated with genital herpes.

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