Long-pulsed Nd:YAG laser treatment of warts: report on a series of 369 cases

Tae Young Han, Ji Ho Lee, Chang Kyun Lee, Ji Young Ahn, Seong Jun Seo, Chang Kwun Hong, Tae Young Han, Ji Ho Lee, Chang Kyun Lee, Ji Young Ahn, Seong Jun Seo, Chang Kwun Hong

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/cm(2). 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.

Keywords: Lasers; Warts.

Figures

Fig. 1
Fig. 1
Average number of treatments according to subtypes of warts.
Fig. 2
Fig. 2
Cumulative clearance by successive treatments.
Fig. 3
Fig. 3
Clearance rates according to number of laser sessions per subtype. Tx, treatment.
Fig. 4
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).
Fig. 5
Fig. 5
(A) Periungual wart. (B) Crusts were formed three days after treatment.
Fig. 6
Fig. 6
(A) Deep palmoplantar wart three days after treatment. (B) After one week. (C) After two weeks.
Fig. 7
Fig. 7
(A) Verruca vulgaris on the toe. (B) Complete clearance after only one treatment session.

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