J Korean Med Sci.  2009 Oct;24(5):889-893. 10.3346/jkms.2009.24.5.889.

Long-Pulsed Nd:YAG Laser Treatment of Warts: Report on a Series of 369 Cases

• Han TY
• Lee JH
• Lee CK
• Ahn JY
• Seo SJ
• Hong CK

• KMID: 1782012
• DOI: http://doi.org/10.3346/jkms.2009.24.5.889

Abstract

Various treatment methods have been adopted in the management of warts; however, there is still no consensus on first-line treatment. This study was designed to evaluate the efficacy of long-pulsed Nd:YAG laser in the treatment of warts. Over the course of 1 yr, 369 patients with recalcitrant or untreated warts were exposed to a long-pulsed Nd:YAG laser. The following parameters were used: spot size, 5 mm; pulse duration, 20 msec; and fluence, 200 J/cm2. No concomitant topical treatment was used. In all, 21 patients were lost during follow up; hence, the data for 348 patients were evaluated. The clearance rate was 96% (336 of the 348 treated warts were eradicated). The clearance rate of verruca vulgaris after the first treatment was very high (72.6%), whereas the clearance rate of deep palmopantar warts after the first treatment was low (44.1%). During a median follow-up period of 2.24 months (range, 2-10 months), 11 relapses were seen (recurrence rate, 3.27%). In conclusion, long-pulsed Nd:YAG laser is safe and effective for the removal or reduction of warts and is less dependent on patient compliance than are other treatment options.

Keyword

Lasers; Warts

MeSH Terms

Adolescent
Adult
Aged
Child
Child, Preschool
Female
Humans
Lasers, Solid-State/*therapeutic use
Male
Middle Aged
Skin Diseases/pathology/*surgery
Treatment Outcome
Warts/pathology/*surgery

Figure

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  Fig. 1 Average number of treatments according to subtypes of warts.

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  Fig. 2 Cumulative clearance by successive treatments.

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  Fig. 3 Clearance rates according to number of laser sessions per subtype. Tx, treatment.

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  Fig. 4 Histopathological findings by H&E staining. (A) Separation of dermo-epidermal junction (×40). (B) Destroyed blood vessels in the dermis surrounded by a dense inflammatory infiltrate (×200).

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  Fig. 5 (A) Periungual wart. (B) Crusts were formed three days after treatment.

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  Fig. 6 (A) Deep palmoplantar wart three days after treatment. (B) After one week. (C) After two weeks.

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  Fig. 7 (A) Verruca vulgaris on the toe. (B) Complete clearance after only one treatment session.

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