الفهرس 
WARTSOnly 14 pages are availabe for public view
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Abstract
Background:
Warts represent a common therapeutic challenge as no therapeutic modality is
considered as uniformly effective or viricidal. Success rates have been highly
reported with electrosurgery and CO2 laser vaporization has been also reported as an
effective, safe and simple therapeutic approach for treatment of warts.
Aim of work:
The aim of this study was to compare CO2 laser treatment (using two
different powers; 1 watt and 3 watts) with that of electrosurgery (6 watts) in
treatment of common warts as regards; efficacy, complications, and healing.
Patients and methods:
Thirty five patients with at least three verrucae vulgaris were involved in this
prospective double blinded clinical trial. Two lesions were treated by the two
different powers of CO2 laser (continuous mode), while the third one was treated by
electrodesiccation in the same setting. Evaluation was done at week 1, week 4 and at
week 12. The effect of the number of passes of both powers of CO2 laser was also
evaluated.
Results:
There was no significant difference between CO2 laser and electrodessication
neither as regards re-epithelialization, development of erythema, post inflammatory
hyperpigmentation nor scar formation. However, secondary infection was
significantly higher in patients treated with electrodesiccation in comparison to
those treated with CO2 laser both at week 1 (P=0.039) and at week 4 follow up
(P=0.042). On the other hand, the incidence of recurrence of the warts was
significantly higher in CO2 laser treated lesions (P=0.020) than in lesions treated by
electrodesiccation at week 4 follow up.
Among the CO2 laser treated lesions at week 4 follow up, earlier healing (reepithelialization)
of the lesions was significantly achieved in the 1 watt treated
lesions more than in the 3 watts treated lesions (P=0.041). However, recurrence was
significantly higher in lesions treated by 1 watt when compared to those treated by 3
watts (P=0.022). Using larger number of CO2 passes than the median was
significantly correlated with a higher incidence of lesional post inflammatory
hyperpigmentation (P=0.008).
Conclusion:
The use of low power output of (3 watts) CO2 shows high cure rates but very
low powers has lower cure rates and significantly higher recurrence. Both
electrodessication and CO2 are effective and relatively safe lines of treatment for
warts. However, electrodessication shows higher cure rates and less recurrence. CO2
shows lower incidence of secondary infection with less morbidity during healing of
lesions. We believe that electrodesiccation still represents the first line of treatment
of cutaneous warts. CO2 may be the proper choice in patients with high risk of
bacterial infection.
Key words: warts, verrucae, electrosurgery, CO2 laser