![]() ![]() The following databases were used to identify studies for this systematic review: Medline 1966 to October 2013, Embase 1980 to October 2013, and The Cochrane Database of Systematic Reviews 2013, issue 9 (1966 to date of issue). One observational study in immunosuppressed renal transplant recipients found that, at 5 years or longer after transplantation, 90% had warts.Ĭlinical Evidence search and appraisal October 2013. ![]() Immunosuppression is another important risk factor. One cross-sectional survey (1086 people) found that the prevalence of warts on the hand was 33% in abattoir workers, 34% in retail butchers, 20% in engineering fitters, and 15% in office workers. Warts on the hand are also an occupational risk for butchers and meat handlers. One observational study (146 adolescents) found that the prevalence of warts on the feet was 27% in those that used a communal shower room and 1.3% in those that used the locker (changing) room. Warts on the feet can be acquired from walking barefoot in areas where other people walk barefoot. They are most common at sites of trauma, such as the hands and feet, and probably result from inoculation of virus into minimally damaged areas of epithelium. Warts are caused by HPV, of which there are over 100 different types. We found limited evidence from one small RCT that photodynamic treatment plus topical salicylic acid may increase the proportion of warts cured compared with placebo plus topical salicylic acid however, it may increase pain or discomfort compared with placebo. We don't know whether duct tape occlusion, pulsed dye laser, photodynamic treatment, or surgery increase cure rates compared with placebo, as few high-quality studies have been found. We found no systematic reviews or RCTs about the effects of intralesional candida antigens. We don't know whether intralesional bleomycin speeds up clearance of warts compared with placebo, as studies have given conflicting results. We found insufficient evidence on the effects of cryotherapy versus placebo.Ĭontact immunotherapy with dinitrochlorobenzene may increase wart clearance compared with placebo, but it can cause inflammation. Topical salicylic acid increases the cure rate of warts compared with placebo.Ĭryotherapy may be as effective at increasing the cure rate of warts as topical salicylic acid, but we don't know about wart recurrence. For what is such a common condition, there are few large, high-quality RCTs available to inform clinical practice. ![]()
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