Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Its been a busy week moving to new domain and new server and new platform. We still have a lot to do. The basic functionality is there, but we working long hours on the rest and awaiting the new design.
    Dismiss Notice

Aldara & Mosaic Veruccae

Discussion in 'General Issues and Discussion Forum' started by Michael Kenning, Dec 4, 2008.

Tags:

  1. Members do not see these Ads. Sign Up.
    Does anyone out there have any experience of a topical cream called Aldara being used on veruccae? A work colleague of mine came up to me the other day and said that she has had a mosaic veruccae for 10 years and that a friend had advised Aldara cream which she is buying for €200 per month. There has been no change so far and she has been using it for two months.I looked it up and it is used for dermatological conditions such as Actinic Keratosis, Superficial Basal Cell Carcinoma and external genital warts. Apparently the action on genital warts is not known but the blurb said it is thought to induce mRNA encoding cytokines including interferon. In a study of 209 subjects it appeared to only have a 50% success rate in complete resolution of the warts. It isn't licensed for plantar warts as far as I can see, and I feel my colleague is wasting her time and money, but I wondered if anyone had seen this cream used for plantar warts?
     
  2. admin

    admin Administrator Staff Member

    Aldara = Imiquimod

    Imiquimod

    Imiquimod (INN) is a prescription medication that acts as an immune response modifier and is used to treat genital warts, superficial basal cell carcinoma, and actinic keratosis. Scientists at 3M's pharmaceuticals division discovered the drug and 3M obtained the first FDA approval in 1997 under the brand Aldara. As of 2015 imiquimod is generic and is available worldwide under many brands.

    1. ^ Cite error: The named reference drugnames was invoked but never defined (see the help page).
     
  3. blinda

    blinda MVP

    Hi Michael,

    I haven`t had any experience in the use of Imiquimod, but aside from the undesirable side effects that it can produce, I wonder just how effective it is on plantar VPs, which are usually caused by Human Papilloma Virus 1, 2 & 4.

    It is indicated for genital warts which are associated with HPV 16 & 18. Imiquimod takes up the `toll like` receptor 7 on specific immune cells in the epidermis. However there is one theory, which is in the process of research, that HPV can locally activate T suppressor cells and that the virally infected cells have no surface markers to bind to.

    Cheers,
    Bel
     
  4. stevewells

    stevewells Active Member

    Hi Michael - just saw this thread
    I was treating a patient recently with relcalcitrant multiple VPs on both feet - long history
    I saw him a number of times - I was using a fairly agressive caustic regime - during the time i was treating him he was treated with Aldara by a dermatologist for facial lesions - he was advised they were a type of wart but he could not recall the exact diagnosis - within 4 weeks his feet had completely cleared!
     
  5. anDRe

    anDRe Active Member

    Hi everyone
    Im a podiatrist from portugal, i have never heard of this cream for treating plantar warts untill today, and after a quick google search i have found this page of a podiatris that as used it back in 2000
    http://www.zfootdoc.com/newpage14.htm

    I would like to know more about this treatment...hope some one can healp me:confused:
    Regards
    AnDRé
     
  6. Julian Head

    Julian Head Active Member

    Hi all

    I have had 5 or 6 patients try Aldara over the past few years, all prescribed the cream by a dermatologist at the local Spire hospital. All had long standing mosaic vps (multiple) and all failed!! Mind you I was failing with acid treatments and electrodessication so they were getting frustrated and desperate to find a cure. 2 of those patients were so fed up they didn't wish to continue with any treatment so I advised them to try 24/7 occlusive taping with duct tape (electrical tape) and the vps went within 8 weeks 2 more found that didn't help either....

    I would not recommend using Aldaraas it is expensive and seemingly pointless.....but the numbers of patients who tried it are small.

    I am really interested in Kevin Kirbys needling technique, under local, and will give it a go inthe near future.

    Anyone else had experience of Aldara?

    Julian
     
  7. shutterbugtn

    shutterbugtn Welcome New Poster

    I know this thread is older, but for those who do a search, my answer might prove helpful.

    I am not a dr. but a mother of a daughter who has suffered with this type of wart for about 4 years now. After 18 weeks of Aldara, with a 2 week break from the medicine due to misplacing it at about 10 weeks, we are now seeing results. Here are the before and after photos to show the effectiveness of the treatment. We have done nothing else to treat in this time frame. We were very discouraged at first because the warts were continuing to spread. Thank heavens we decided to continue the treatment until we used up all of the medicine.

    Before:

    [​IMG]

    After:

    [​IMG]


    I hope this gives hope to someone. The after photo was taken 2 days ago and even today many of the warts in the after photo are noticeably smaller or gone.
     
  8. andrea34

    andrea34 Member

    hi
    i have had several patients who have had very successful results with aldara usually within a 4wk period, although never used it on mosaic vp so cant comment on its success there
     
  9. blinda

    blinda MVP

    I agree with Julian. Whilst there have been cases where Imiquimod has obviously aided resolution of VP`s, the mode of action for the HPV types peculiar to the feet and hands, is still not clearly understood.

    Indeed, the high cost, the side effects and lack of evidence would not encourage me to recommend Imiquimod as an appropriate tx for VP.

    Just my opinion, of course.

    Cheers,
    Bel
     
  10. MJJ

    MJJ Active Member

    I have had patients who have used it successfully, after other treatments have failed, and some who have used it with no success.
     
  11. Julian Head

    Julian Head Active Member

    anyone any updates on aldara use and its efficacy?
     
  12. mjfpodi

    mjfpodi Member

    Hi Pod Community!

    In our practice we have had a few stubborn VPs that we have referred onto a dermatologist Dr Tim Sonnex and our patients are reporting that he has cleared their VPs after only three NO2 treatments (when we have done between 8-12 ourselves??? :hammer:) the only thing he does differently from us according to our patients is get them to use imiquimod cream between visits.

    Has anyone seen any interesting/positive studies regarding this as a treatment option?

    Any assistance is much appreciated, thank you!
     
  13. Leah Claydon

    Leah Claydon Active Member

    Aldara seems to have a similar action to Efudex Cream (Valiant Pharmaceuticals) 5% Flouroucil which if memory serves me correctly is an antimitotic. This too is prescribed for BCCs and I believe is/was licensed for use on VPs in the USA but not in the UK. There was a paper published in Podiatry Now in, I believe, 2006 suggesting good efficacy.

    I used it occasionally when I practised in Cyprus (lax laws on POMs made it available to the general public [very bad, I know]) - it worked very well on recalcitrant lesions. It was very expensive however - around £45 for a tiny tube - but many patients liked using it due to its convenience and lack of pain.

    http://www.rxlist.com/efudex-drug.htm
     
  14. mjfpodi

    mjfpodi Member

    Thank you Leah that is really helpful!

    Did you use it in conjunction with NO2 treatment? Do you recall if many of your patients had to use it for up to 16 weeks? (That would be expensive :wacko:)

    Sorry for all of the questions. Have a great weekend!!!
     
  15. Leah Claydon

    Leah Claydon Active Member

    Patients started to see a difference in the lesion(s) fairly quickly. They used it under a hydrocolloid dressing such as sorboskin or granuflex and lesions usually cleared (if they responded) within 6 weeks.

    I notice that you are in located in the UK - I think you will have difficulty in acquiring 5% Fluoroucil in the UK - it's not licensed for use on VPs in the UK.
     
Loading...

Share This Page