Mosaic verrucae-help with treatment

Hi Clair,

I charge the same as for a nail surgery. Price also includes post op reviews.

Hope that helps.

Regards,

 

Hey Mand`

Are you still doing it under post tib blocks or are you using local infiltration more?
I became impatient with waiting, so find myself using local infiltration more.

Cheers,
Bel

 

Blinda,

I still use tibial blocks, however i use them all day everyday in surgery. However the more you do the quicker they go. I also tend to top up with Bupivicaine / levobupivicaine either as tibial again or local infil for post op pain relief.

 

Hi Bel,

Local infiltration now as the tib' blocks (as Kevin & others suggested) can take a little long to 'go off'. The Ethyl Chloride spray seems to help with initial pain of jab.

ttfn X Mand'

 

hi all,
had another VP pt in this week for what i now call verruca immune stimulation therapy (VIS therapy) or needling for the rest of you. anyway, this pt's father also has a VP and was interested to know the success rate as a %...anyone out there prepared to put an average on your successes?

still not got a camera yet so no pics...will try to get one soon and then hope to add to the images.

thanks again to everyone who has contributed to this fantastic thread.

poppet

 

Hi,

Having studied in the UK my LA training started and ceased at nail surgery. I find this thread both interesting and practical, is there anyone that can advise where i can get training for LA blocks and needling. It is a treatment i would like to offer my disillusioned vp patients. Would be more than happy to travel for training.

 

Routinely, I use cryosurgery post lesion debridement for plantar verrucae. In resistant cases, or very large or high-number multiple lesions, I use treatment by inoculation. I choose either the largest lesion, ceteris paribus, or one that is less susceptable to shear (hence, assumedly, less likely to cause discomfort during immediate post-treatment weight-bearing).
It has always resolved the problem.
In one case, in which the lesions had a 10 year history, it was necessary to inoculate twice. This patient was 87 years of age. Oddly, most of the lesions resolved with the first treatment, but there were, apparently resistant lesions (B) that necessitated the second treatment. Inoculation of one lesion led to resolution of extensive lesions, both in size and number, on both feet.
In another case, the patient had a history of verrucae on her fingers as well. I was surprised to see that these, without direct treatment, resolved as well. The patient was delighted; she'd been using an OTC prep to freeze them, with which they would fall off, then recur.
All and all, this treatment modality is an important part of our amentarium.

 

sorry can you expand on Inoculation for me

 

This is (perhaps unfortunately) another name for the technique described by the esteemed Dr. Kirby on the first page of this topic as "multiple puncture technique". Sorry to obsfucate via nomemclature change.

 

Doug:

Good to see some of my former students join the discussions here. Hope all is well. Welcome to Podiatry Arena!

 

great photo's!what camera do you use

 

It would help if it was known where you are??

 

Poppet

Pot Permang is a treatment over 40 years old, it was at that time the in thing to use, especially in individual infection cases.
If you are into alternate therapies, try this:
First of all get the patient to swab inside of all footwear with a diluted solution of common Bleach Sodium Hypochloride, this should be undertaken twice daily, what seems to be happening is re-innoculation of the VP virus. (in damp moist enclosed area's)
It may be difficult as the plantar aspect appears to be completely covered, but try
applying a dressing of pure Vitamin E 600 to 800 iu oil on gauze to completey occlude the area, this requires to be changed twice daily and after bathing. The patient will have to undertake this themselves, the Vit E will cause growth of the tissue and will require pumice or emery boarding on the third day. This may have to be carried out for 2-4 weeks, so is a monotonous procedure. see the patient frequently to remove any callousity.

It works very well on individual infection and ideal for small children. If you consider that the majority of ladies creams have Vit e in them which cause skin imperfections to clear by regenerating and enhancing tissue growth.

It can be messy but is natural and worth a try.

David Crew.
Author: The Axolotl Theory. Tissue regeneration (iocp 1974)
The Treatment of Verrucae Pedis by Vitamin E. (icop 1975)

 

Hi David,

Good to see you posting here. Interesting thoughts.

Occlusion of VP is a viable `soft` option for VP tx, although tricky with mosaic type as described by Poppet. Do you know of any studies that have been carried out to identify any anti-fungal properties in vit E?

Cheers,
Bel

see you in Nottingham

 

DOH! of course I meant "anti-viral" not "ant-fungal". Had tinea on my brain last night (not a pleasant image I know) as was writing a GP letter :dizzy:

Dizzy
Bel

 

Hi Poppet

I debride down as much as I can and Moores if needed.

Either using a Cryopen or I also use low level laser and then currently use Salactol over them all. Sell the patient a bottle and instruct to remove excess every day either with file or rub in shower and then reapply Salactol.

Review in one week or two weeks or whenever you like and keep going with the treatment.

I tend to use Salactol over Occlusal as I am getting some great results with it, but have also used Glutarol too.

Just cleared one patient ((72 yrs old) with bilateral entire feet covered in them and one extended 2 inches out from her left 1st MTP so it flapped out of her sandles when she came in. She'd had them for around 10 yrs and is now wearing occlusive shoes for the first time in 5 yrs. She is a happy bunny and so am I

It was a bit like carving rare beef to start with!

Hope it helps

Nick

 

Would someone be able to explain how they perform the local infiltration for me? Are you using a spray prior to injection? Im trying to get my boss to say yes on this so need to give him as much info as possible.

Thank you!

 

Hi Paul,

There are a lot of posts to scroll through. Well worth reading them all though.

I hope these two help.

Regards,

Mandy.

 

I have now treated 3 patients with this method, and have more booked in. I found a friendly podiatrist who has been doing this for some time. He let me observe which gave me a clear idea of what to do and expect. I then felt confident to do this myself. (I am a fairly new pod and like a degree of hand holding!) I am looking forward to seeing the results.

 

Thanks twirly thats great, Ill have another good read through from the start. Has anyone got any more pictures of post ops? I like pictures!

 

I have just seen my first patient 3 weeks after needling. The results are fantastic. I have great pre , post and todays pictures. Will figure out how to attach and get them on this post. I am amazed. Brilliant treatment and my patient is very happy.

 

I have used potassium permanganate foot soaks for VP's with success but not on their own. Having tried other treatments without success, the 15 minutes a day for a week foot soaks provide an alternative to enable you to keep attacking the virus. They were also a welcome relief for the patient from having their feet covered with occlusive dressings for a six week stint of salicylic acid treatments. The soaks do turn the nails brown (as indeed they do the bowl and the towel used!) but this will come off with burring. You can then commence or recommence another treatment afterwards if necessary.

Good luck

 

Hi I am an HPC (UK) trained podiatrist, does anyone know where training for this techinique is available in the UK.

 

Where are you? - it will just be a case of you observing a colleague then having a go yourself!
YOu would be welcome to observe at my clinic (I am in Epsom) Send me a PM if you are interested

regards

Steve Wells

 

Hi Steve,
thanks for your reply, I am currently working in Gibraltar, but I will be over in London for a week as from 12th May, maybe we could meet up then if that is fine with you.

Regards

Kayron

 

My answer may well be laughed out of this forum, but, it has had quite some success throughout the last 15 years or so that I have been using it.

I debride the areas of the main warts until there is pin prick haemorrhaging - in order to elicit an immune response, then I use a very thin slice of fresh garlic on the wart (it does sting), being careful to mask the unaffected skin around the wart. Then a dressing is placed over the area for approximately 12 hours. The patient is then advised to remove the dressing and re-dress with thin slices of garlic every day for about 5 days. If the patient is compliant this method is more often than not successful in helping the regression of the warts.

It is important to mask the areas around the wart as the garlic may cause blistering.

I would be interested to know if anyone else has tried this method ...

 

Hi there,
I have never tried this type of "unconventional" treatment, but how do you combat the garlic smell?
Regards, Vernon.:bash:

 

I once had a friend use the "milk" from a milkweed plant under bandaid occlusion on their plantar wart quite successfully after a wart currettement procedure had failed. Like I tell my patients, there are probably 30 or more known treatments for plantar warts, and none of them are 100% effective.

 

Ah well ... unfortunately that is the drawback, but if the patient is prepared to put up with the smell, it is worth the chance of a potential cure.

 

Hi guys! I thing this topic is very intresting, how would you administer the LA? in what type of way? also if the VP's were very big or all over the foot would you consider using a tibial nerve block?
Thank you
Simon

 

Hello there - no laughter from me about using garlic on the good old verrucae - have used it successfully on several people and for as long as you. The main disadvantage of it is the smell and hence the lack of persistence of the client to stick with it. However, the most successful was with my own 4 year old son who acquired his plantar wart (and someone may well laugh at me here) from a toad that hid in his shoe and I insisted on pushing his foot into it until he exclaimed that there was something in the shoe!!! But anyway, the garlic on the hideous growth on the plantar aspect of his second digit every night for several weeks worked a treat. Good luck - its probably the most effective remedy yet.

 

How does using it successfully on several people make it the most effective remedy yet?

 

TO all our Aussie mates out there (and Admin) - does anyone know a Pod in the Hobart Tasmania area that does needling - I have a patient that is moving out there and would like some help please

cheers

Steve

 

Hi.

I Had two patients in this morning with VP's of long standing. I needled both and will let you know whether they resolve. The first patient, new to me, had a VP on the lateral border of the heel and treatment went well. The other patient had had the VP for about eighteen months, it was central, proximal just about under the area of heel strike. This went well but there was some bleeding. This led me to consider a caution to avoid turning a blood vessel into ground beef!

Sorry no pics as camera at home.

Luke

 

The chemical is POTASSIUM PERMANGANATE. It is a very old fashioned remedy and was called Condy's fluid of Condy's crystals after the chemist who first made it in London over a 100 years ago. In a dilute solution ot is a disinfectant and can be used for fungal nail infections. One drawback is that it stains the skin brownish

Zsuzsanna

 

In my early days I used successfully with Thuya occidentalis homeopathic treatment.
Currently not using this treatment.
Many are the paths that lead us eventually to the right place.
Teatino greetings

 

Assume you have tried Gluterol. I have found it useful in mosaics for many years.

 

Any information Gluterol wider?
Administration guidelines, composition, etc.
Thanks Teatino

 

Supplied ixn dropper bottles (amber) and applied three times a week initially and then once a week to the verrucae. If very severe daily for a week.

Let it dry before patient replaces hosiery. Hope this helps.

 

hi kevin,
what if the patient is/may be immunocompromised? is it possible to spread the virus deeper within the tissue and do more harm? i ask this as most treatments aim to stimulate an immume response
magda