Comparative study of the efficacy of cryotherapy verus topical 5-fluorouracil in the treatment of resistant common warts

Abstract

Background: Wart is a common disease which is caused by a group of viruses called Human Papilloma Virus. The most type of wart is common wart and the most prevalent site of involvement is hand. Complete recovery, no recurrence and effectiveness in all patients are not obtained by any of therapeutic methods, so in this study we decided to compare therapeutic effects of 5-FU with cryotherapy in treatment of common warts of backhand. Methods: In a one year period from March 2012 to March 2013, 60 patients that referred to dermatology clinic of Sina hospital with the diagnosis of backhand wart included the study. Patients were divided into two groups, one treated with cryotherapy (30 patients) and one threated with 5-FU (30 patients). Age and gender of patients, number of lesions and duration of involvement were documented. Treatment by topical 5-FU was implemented twice a day for 4 hours each course for 4 weeks, Second group was treated by cryotherapy (liquid nitrogen spray), two sessions with a two-week interval between sessions. Their response to treatment was evaluated as good, moderate and weak. Results: There was no difference in age, gender and mean of duration involvement and number of lesions between two groups. Response to treatment was considerably better in 5-FU group: 60% compared with 26.7% (P=0.02). Rate of complications were lower in 5-FU group of treatment, with a statistically significant difference compared to the cryotherapy group (P<0.001) too. In separate evaluation of complications only scar formation was equal in two groups and pain and bullae formation were lower in 5-FU group with a statistically significant difference (P<0.001 both). Conclusion: According to limited studies in this field, results of this study could be the base of more comprehensive studies in evaluating the efficacy of 5-FU in treatment of common warts. Appropriate therapeutic response in addition to lower rates of complications by 5-FU treatments can make a major change and lower the psychosocial burden of this disease dramatically.