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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....

 

Have you thought about needling?

 

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.

• First published: 1 November 2017Full publication history
• DOI: 10.1111/bjd.1575

 

I would try needling there has been some amazing photos before and after. What have you got to loose?

 

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