Congratulations to Belinda Longhurst (Blinda) for a very nice paper just published on Falknor's needling technique for verrucae plantaris.:drinks
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The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Ivan and I owe you a beer or two.
Cheers,
Bel -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
And you know I consider you the Goddess of Podiatric Dermatology.....don't you? ;) Keep up the great work!:drinks -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Other threads tagged with dry needling -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Thank you for this.
Only discovered needling 12 months ago, but so far VERY happy with results. Great to have some recent, "official" literature to refer to. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Thanks Bel :drinks
What took you so long ;) -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Great work Bel
though I would `thank you` as you wrote the paper as all, Hope you don´t mind Kevin -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Cheers,
Bel -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
A brilliant paper. For me the highlight was the background information. Well done you. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Started reading this lunchtime and got a bit more to go. Excellent reading in that it is firstly readable!! Not always easy to do with a paper. Like Rob I have enjoyed and found the back ground stuff really helpful. Look forward to the rest. Biggest praise Bel? Persisting against and overcoming the stumbling blocks along the way. Well done. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Thank you Bel - an excellent piece of work! -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Well done.
I'd be interested to know if those who perform this procedure frequently have a similar success rate, and what possible reasons you can give for the failures.
For instance; the failures I have had, or the times I have had to repeat the procedure seem to be more for digital verrucae.
Also large mosaic verrucae with a large number of satellite lesions (even on the other foot) seem to have the highest success rate.
Steve -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
I would say my success rate hovers around 75%, but I've never done a study of this. In fact, as far as I'm concerned, Bel is now the expert on this procedure....I was just the one that remembered reading Falknor's paper in 1984 and trying it on a few of my patients. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Thanks Bel - just printed a copy and will have a read this evening. :drinks
Kind regards,
Dave -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Since writing the review, I have been discussing this with a few who are interested. Well, mainly Robert Isaacs as he is coming round to the idea that dermatology is cool...
I`ve always suspected that HPV sub-type has a bearing on tx success;
HPV1 (single) is notoriously stubborn as it creates a huge amount of vacuolization - hence the rubbery, macerated texture and far more disturbance of cell differentiation through the entire thickness of the epidermis than HPV2 & 4.
HPV2 (mosaic) produces some vacuolization in the spiny and granular layers, leading to a honeycomb-like picture on histology as it proliferates. This is probably the most superficial sub-type, so could explain why you are observing a higher success rate.
HPV4 (multiple) causes a thicker granular layer only, but a more compact horny layer.
Fascinating, eh? Or is it just me?
Cheers,
Bel -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Basically, you gotta stimulate those cytokines any which way you can. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
http://www.podiatry-arena.com/podiatry-forum/showthread.php?p=287008&highlight=HPV1#post287008 -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Might find this interesting:
Don't recall if I told the arena on the original thread for Faukner's procedure...but I met him while in school in the late 70s in Chicago. He was a guest lecturer and, obviously, lectured on his needling technique.
What I remember most is that he made a rather grand entrance into our lecture room from the rear of the classroom once we were all seated. He wore a black cape!
Not easy to wear a cape...you need a particular personality to get away with it...he had it. Quite flamboyant.
Steve -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Hey well done Belinda, Just printed it off for some quiet reading tonight by the telly.
:drinks
Regards Dave Smith -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
What gauge needle is everyone using? I know the ubiquitous 27 g is standard but I've seen a few done with a much larger needle (18g I think). It worked where the 27g had not but I worry about scarring with a needle that big. What's your weapon of choice over the water? -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Thanks -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Hey forgot to ask something, does anyone uses this technique in "normal" warts or just mosaic ones? Is the post-operative to painful or not? -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
I have not performed this technique, but to the neutral reader here is where I'm getting confused:
Blinda wrote:
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
When I first started utilising the needling method, I noticed that HPV1 sub-types appeared to form a thicker capsule which increased resistance to tissue destruction. On more than a few occasions, once the lesion was punctured to the point of no reactive pressure, the mass would visibly `bulge`. A few patients reported this protrusion as uncomfortable post operatively, so I decided to use blunt dissection in careful removal of the needled mass and was surprised at how easily the lesion came away as the epidermal tissue had already separated from the dermis. So there is no cutting of the dermis, just a pulling away of the pulverised lesion and little chance of scarring.
That said, with the right technique, blunt dissection alone should not produce scarring either.
Incidentally, I did not the use patients whom I used secondary blunt dissection on in the review. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Just out of curiosity, how are you classifying your lesions? What other strains of HPV form plantar warts? -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
In primary blunt dissection, you need to cut the epidermis away from the dermis, so there is an increased risk of scarring. You also don`t expose latent viral particles to the subcutaneous layer so, theoretically, there is a reduced presentation of these to the immune system. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
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Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Interesting point re cemetidine, Paul. What dosage do you recommend? -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
By the way, I use a Miltex curette for blunt dissection and the verrucae will practically "pop out" using proper technique with this instrument. I've never had any scarring to my patients with 30 years of using blunt dissection. However, without proper technique and instrumentation, scarring is not only possible, but is quite likely to occur with the blunt dissection technique. -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
The most scarring I have ever seen is from a colleague who was using cryotherapy weekly on a lesion sub 1st for almost 12 months! By the time she got to me there was no wart simply prolific scar tissue.....I think they were applying "cryo" to scar tissue.....for most of the treatment! -
Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases
Kevin
I took this from another thread
Now I'm not sure, can you clarify please ?
Cheers
D;)
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