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Verrucae Pedis

Discussion in 'General Issues and Discussion Forum' started by gina chiles, May 26, 2008.

  1. gina chiles

    gina chiles Member

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    Hi all,

    I'm a third year Podiatry student and would be grateful for some advice re the following:-

    I am based in the UK but my sister lives in Australia and has been suffering from plantar verrucae for the last 15 years. They are mainly on one foot but in last year have spread to other foot. The main concentration is on lateral aspect of left foot and measures roughly 2 by 5 cm with satellite verrucae surrounding. Also on hallux of same foot. Also a couple on right foot in crease of lesser toes which bleed often.

    Recently she has been having Podiatric treatment with 80% salicylic acid twice a week for 3 months on main verucca - 60% on others. They have reduced slightly but no major change.

    She is 33 years old and not taking any medication.

    She is returning to the UK next month for two months and I would like to try to treat them - any advice?
  2. "Sigh"

    Where vps are concerned chuck a rock in a conference and you'll hit a theory. Destructive txs are pretty much the only ones with hard evidence of success although duct tape and low level laser have their followers...

    Sounds like she's been hitting the caustics quite hard already, not sure i would be happy to up the doseage there!

    For what its worth on a lesion that size i would be thinking occlusion (duct tape / granuflex) AND low level laser if you can find somebody who has the toy.

    Alternatively try the dead cat method. Its irrational and makes no medical sense. Just like 80 % of the other treatments on The List.

    These are all for real and have been used with reported success:wacko:

    dead cats,
    stump water,
    going to 4 funerals,
    bean skin,
    snail slime,
    nutsake mushrooms,
    essential oils,
    potato skin,
    baked onion,
    epsom salts,
    tea tree oil
    cider vinegar,
    mashed banana,
    unheated honey (and it was specified that it must be unheated),
    mango and papaya juice
    danylion roots,
    mustard cress,
    black pepper

    Strikes me you could just do a casserole and put that on and you'd cover a good portion of the list

  3. Adrian Misseri

    Adrian Misseri Active Member

    I've had some success with heavy debridement then application of phenol followed by an alcohol flush, repeat weekly. Seems to work on kids with persistent mosaic toe warts too. Alternatively buying them off her for a nomimal fee ($5, maybe $10 being that there's so many of them) seems to work nicely too......
  4. L Sempka

    L Sempka Member

    Have a go at debriding the thing then mixing up some monochloric acid with 60% salcylic acid and applied and grind on with a AgNo3 applicator. Cover with an occlusive tape and leave for 48hrs.
    Get the patient to apply ordinary ointments from the pharmacy 4 1-2 weeks, being careful of the amount not to cause too much issues then review.
  5. DAVOhorn

    DAVOhorn Well-Known Member

    Dear All,

    As previously said we all know hundreds of tt that dont work reliably and have no reliable effective tt.:deadhorse:

    My favourite is LIQUID NITROGEN.:drinks

    I still use cryo but not as cold as Liquid Litrogen only -50c freezing agent.

    Potent caustics leading to tissue breakdown and ulceration which then heals is a fairly brutal tt regime and should only be used when pt understands that you are endeavouring to cause maximum damage.:butcher:

    Otherwise pt may be very upset at the degree of tissue damage.:boohoo:

    In children i have found the PLACEBO effect is best.

    Under 5 yrs buy it for a few dollars.

    Over 5 years get the child to wish it away.

    But the evidence is still that the MOST clinically effective tt in children is nothing. It is 90% successful over 2 years and 50% effective over 6 months.

    Nothing has changed since 1986, or even when i was 11 years (afew years ago) of age and had my 30 warts tt with liquid nitrogen.

    So we need a new modality .

    regards David
  6. blinda

    blinda MVP

    I have had painful mosaic VP on my right plantar calcaneal area, a single VP on the dorsum of same foot and one very large VP on my left plantar calcaneal for the past 8 years.

    Tried EVERYTHING under the sun (occlusion reduced the size but did not clear them) and became so desperate to get my hands on some Cantharidin (which I know is not licensed for podiatric use in the UK) that I placed all hope on this magical substance working. Guess what? Soon as i obtain some, they all become inflamed, raised and pruritic without even opening the bottle! Today, I checked and 3 large ones have completely disappeared and the others are receding.

    Positive thinking? Working thus far.

  7. gina chiles

    gina chiles Member

    Thank you all for your comments and advice.
  8. kitos

    kitos Active Member

    I use a low level laser with some excellent results. Hit it hard with 3 sessions over about 10 days and then weekly/bi weekly covering with duct tape in between. Have had some dramatic success with mosaic's long term VP's.
    See Omega laser website in the UK for other testimonials/treatments (not from me BTW)

    Best wishes
  9. pd6crai

    pd6crai Active Member

    The whole buying for a dollar??!!! Do you say you will buy it and hand over money before or after its gone?! I get confused. Would work brilliantly (probably with my nephew!)
  10. DAVOhorn

    DAVOhorn Well-Known Member

    This is using the PLACEBO EFFECT or Power Of Suggestion.:santa2:

    So you make a song and dance of buyng the wart off the child really affirm that buying the wart you will result in it going.

    So yes you give the child the money whan you buy it.

    This affirms in the childs mind that it has been bought and that therefor it will go away.:drinks

    Really successful in under fives.

    If it is unsuccessful you have lost a dollar or two and the kid has bought an ice cream with the money.

    regards David
  11. lcp

    lcp Active Member

    have had a long term patient with vp, nothing really worked to great extent. she got the cervical cancer vaccine, then they all disappeared. coincidence? maybe, but pretty trippy nonetheless.
  12. DAVOhorn

    DAVOhorn Well-Known Member

    I understood that the vaccine was specific for the 4 ? viruses that are implicated in Cervical Cancer.

    So if the VP regressed due to Gardasil this is important and may be of interest to the profession.

    I could also be wrong and this could have been incidental.

    regards David
  13. spike123horse

    spike123horse Active Member

    I've had some sucess with tea tree oil, but could be coincidence? Also duct tape works for some folk - wish I had the nerve to recommend the dead cat??????? Have had success with small ulcers using unheated honey - the stuff is supposed not to be heated as this destroys the active ingredient in the propolis, so I've been told by beekeeper friends.
  14. Liz C

    Liz C Member

    Can someone explain the theory behind a treatment method of activating silver nitrate sticks with phenol then applying to the VP! Im a little lost on this method- something that has been reccomended by a collegue before treating with regular 80% sal acid every three days (masked, and padded of course)
  15. Bug

    Bug Well-Known Member

    I'm with David. I have a wart wand that is bright and flashy. I'm sure I have put out my wart fairy theory here before also.
  16. Admin2

    Admin2 Administrator Staff Member

    Other threads tagged with Verruca
  17. betafeet

    betafeet Active Member

    Not heard of this one has any one else?

  18. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi, no in almost 30 years have not heard of this one either?
  19. heleneaustin

    heleneaustin Active Member

    I have found varying degrees of success with a few preps like posalfilin (care not to overuse), pyragallol (limited use of no more than 4 applications), sal acid with monochlor xrystals( causes an ulceration), and sal acid on its own. Usually we use agno3 to start with but patients have also found that Duct tape is highly effective and banana skin too. As for the duct tape it does seem to work but again only on a few patients. I believe VPs to be self limiting.
  20. betafeet

    betafeet Active Member

    Dont think you can get posalfilin in the UK anymore? certainly not over the counter anyway.

  21. heleneaustin

    heleneaustin Active Member

    The patient i used it on had it prescribed by the GP.
  22. missbaker

    missbaker Welcome New Poster

    Has she considered cryotherapy? Or another alternative method.

    Also how frequent does she have the salacylic applied?

    What hobbies does she take part in. Whats her diet like?

    Hope this is of some use.

    Is she pregnant?

    podiatry forum member?
  23. gina chiles

    gina chiles Member

    She has tried cryotherapy on one occasion which she found exremely painful but I think now out of sheer desperation she would be willing to try it again.

    She was having the salycilic applied twice a week by a local Podiatrist in Brisbane with the dressing remaining in place in between treatments.

    Her diet is well balanced, and she has two children under 3 so hobbies are restricted mainly to childrens activities.
  24. missbaker

    missbaker Welcome New Poster

    how long has she had the verrucae and when was it that she had the cryotherapy? Also laser is considered useful.
  25. Dieter Fellner

    Dieter Fellner Well-Known Member

    Re: Verrucae Pedis - Cantharidin

    Not kept up with latest VP treatment fashions but the mention of Cantharidin is novel !

    mmm. well if the substance can kill people I guess it can do away with VP's ?

    A Podiatry tutor (1980's) did a trial on pantar VP's injecting sodium bicarbonate into the lesions. By all accounts results were promising. Off label use ! Not sure if this study ever got written up ....

    Attached Files:

  26. blinda

    blinda MVP

    Hi Dieter,

    Tis true. I heard that dermatologists at Alder Hay Royal Liverpool NHS trust are using Cantharidin for VPs, with excellent results, on children. I understand that it is licensed for use in Podiatry in Canada and the States, but not here because of the risk of severe burn and systemic reaction.

    Anyway, my little blighters have now completely disappeared and the seal remains in tact on the bottle. I think the thought of painful blisters has kicked my anti microbial peptides into action!

  27. ives

    ives Member

    one to add to this list is banana skin.

    a 37y/o male patient had been throught the mill since the age of 5y/o with all various Tx, incl. surgical removal. he heard on a radio chat show with a homeopath to use banana skin, fleshy side down, for 5 nights....

    he subsequently came to me after the 5 Tx's. WORKED brilliantly! after A LOT of debridement, all but one of the verucae had dried up and dissapeared.
  28. Dieter Fellner

    Dieter Fellner Well-Known Member

    The cure for VP's rests with activation of the patient's immune system. A perceived 'threat' I have observed over the years, appears to kick start just such a response, sometimes. Quite possibly a part of the flight-fight response.

    I knew of a dermatologist who would approach his patients after dipping a cotton wool bud in liquid nitrogen. He would do so in the opposite corner of the room and make his way towards his victim. The excess fluid dripping on the floor would leave a menacing trail of tiny explosions, worthy of any sci-fi adventure film.

    This heavily bearded and bushy eye browed clinician peering over his reading glasses, had a quite menacing look about him even before he was so armed. This impression combined with a practiced maniacal facial expression, aroused some degree of anxiety, even in myself, the passively observant, and out of harms’ way, student.

    Man, you could virtually see the VP's receding before your very eyes !!!

    Now I speculate, the prospect of having your skin burnt off from the application of the secretions of some sexually charged, horny insect could have a comparable effect, conceivably ?
  29. Dieter Fellner

    Dieter Fellner Well-Known Member

    ha ha ha

    man, lets have a competition .... best cooking recipe from the above ingredients

    too funny !
  30. blinda

    blinda MVP

    Brillliant! Must try the scare tactic on pts.

  31. ives

    ives Member

    my Tx of choice at the moment is a combination of cryo and salicylic acid (Trans-Ver-Sal Patches, 15% Sal Acid), in no specific order. i decide on the day, which Tx to go with, and at times, nuke (cryo) the VP and start with the patches the same day. Pt returns once weekly for assessment and Tx.
  32. blinda

    blinda MVP

    Howzit Ives

    Are the Trans-Ver-Sal Patches only available in SA? I haven`t come across them in the UK.

  33. tarik amir

    tarik amir Active Member

    we have had great success with application of nitric acid after debridement.
  34. pd6crai

    pd6crai Active Member

    If she has had cryp before she could well have been left with scar tissue. I personally have had cryo a few times and electrosurgery and have now got a scar. It could be mistaken for a VP.
    I find the banana skins does help to reduce pain and the increased build up of callous. Personally I think the more you treat VPs aggressively the more resistent they become.

    Go homeopatic, and positive thinking and they will go.......eventually!!!

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