Mohammad Asad Haroon1 , Tapan Kumar Dhali2 , Arpana Rijal3 , Sudha Agrawal4
BACKGROUND Wart is a common dermatological condition resulting from infection with human papilloma virus. Clinical management of warts is often challenging as no therapy has proven to be 100 % effective. Evidence based literature for treatment of warts based on newer modalities is yet to be subjected to large, rigorous, blinded, randomized-controlled trials. Carbon dioxide laser, electrocautery and high frequency radiosurgery ablation are most commonly used in clinical settings but the available literature on the efficacies of these modalities is mainly retrospective and comparative data is scarce. This prospective blinded randomized controlled clinical trial was aimed at providing the best comparative evidence for treating warts with the above three mentioned modalities in terms of cure rate, side-effects and recurrences. METHODS In total 192 patients were enrolled and randomized into carbon dioxide laser, electrocautery and high frequency radiosurgery ablation treatment groups (1 : 1 : 1). Patients were given a maximum of 4 sittings one week apart. The response and complications were documented at 1 st , 4 th , 8 th and 12th week post-procedure. RESULTS Complete cure was achieved with high frequency radiosurgery ablation in 98.3 % patients. This was followed by electrocautery and carbon dioxide laser group with cure rates being 87.3 % and 83.6 % respectively. High frequency radiosurgery ablation also had lesser complications compared to the other treatment groups. Electrocautery was associated with highest side effects. CONCLUSIONS High frequency radiosurgery ablation was found superior to both carbon dioxide laser and electrocautery in the treatment of warts.
