Verruca Treatment

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Hi guys,

Really need some help from Pods who have significant experience in the treatment of verruca pedis.

Now I know it's a tricky one...

Have a 58 year old man, has mosaic VP on his R/PMA. 5 years duration. Has tried all salicylic acid based treatments, with no success.

Have advised leaving it and ways to boost immune system but he doesn't seem to want to do this. I have explained no cure due to HPV, but he wants to see some improvement. At the moment I'm debriding every 4 weeks. I wouldn't say it's the worst I've seen, and doesn't take much debriding to make it bleed. He is quite active and says he is in pain.

Can anyone give me a method that they have found to work along with debridement?

Many thanks
Kirsty (3 years experience)

 

Why not surgically remove it with some local anaesthetic field or PT block, esmarch bandage and then cauterize with phenol? If your not comfortable doing that maybe a colleague locally or Pod surgeon can assist in your area.

Alternatively tagamet (oral cimetidine) 300mg a day for 12 weeks has good reports in the literature of up to 80% resolution rate in adults for plantar verrucae if your patient is not keen on minor surgery.

 

With severe P/mosaic VP I debride weekly, as the re-growth is controlled and weight-bearing pain somewhat lessened.
Cushioning in his footwear will also help reduce pressure and alleviate some pain from walking.

As Paul says, surgical excision may just be the only option in this case. Depending on how extensive the growth pattern is, you may chose to focus on the "mother" of the group. I have found that as the larger lesion is removed the smaller ones heal quickly with just debridement.

However, don't attempt any treatment you are not comfortable with or that is outside your scope of practise.

Good luck

 

Hi Kirsty.

Have you considered the "Multiple Puncture Technique"... as outlined in this thread (link).

Dr (Prof.) Kirby's posts on the topic are very informative, thus take note of those in particular.