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Resilient Verruca advice

Discussion in 'United Kingdom' started by DebG, Mar 8, 2018.

  1. DebG

    DebG Welcome New Poster


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    Please can anyone help me. I have a patient with a resilient mosaic VP. I’ve used Cryo, Sal acid (60%) and now silver nitrate twice weekley. I’m doing the treatment for free now it’s been so long since I started out all positive. I have monochlor but last time I tried this I had a terrible reaction.
    Any suggestions? I can’t afford the SWIFT microwave system....
     
  2. Catfoot

    Catfoot Well-Known Member

    Have you thought about needling?
     
  3. Johnpod

    Johnpod Active Member

    The British Journal of Dermatology has this:
    The EVerT2 (Effective Verruca Treatments 2) trial: a randomized controlled trial of needling vs. nonsurgical debridement for the treatment of plantar verrucae

    Hashmi et al

    http://usir.salford.ac.uk/42625/10/Hashmi_et_al-2017-British_Journal_of_Dermatology.pdf

    Note the date. This trial concludes that needling is no more effective than debridement and is associated with greater cost. The work has been praised for its rigour and the manner in which it was conducted. It also looked at 60 cases - not 46 cases as in Longhurst and Bristow.
     
  4. I would try needling there has been some amazing photos before and after. What have you got to loose?
     
  5. Dieter Fellner

    Dieter Fellner Well-Known Member

    My algorithm:

    1. Home treatment with OTC (any) topical for 2 weeks with daily home debridement and duct tape cover (works 20-30%)
    2. Cantharadin (1-2 weekly interval applied in clinic, usually this resolves the problem 95%)
    3. Folkner's Needling -takes care of the next 4%
    4. Surgical excision - rarely necessary
     
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