Letters to the Editor
Cutaneous Warts: Is Surgical Excision Still A Viable Option?
FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.
FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.
Am Fam Physician. 2005 Dec 15;72(12) Online.
to the editor: I enjoyed the article on therapy for cutaneous warts1 in the August 15, 2005, issue of American Family Physician. However, the authors did not discuss surgical excision of cutaneous warts. Many family physicians and surgeons still practice this therapeutic option in some parts of the world, especially in Africa, where the other methods are not readily available. I have had to surgically excise genital warts while practicing in Mozambique, one of the poorest countries in the world. Is there evidence to support the efficacy of this treatment method, or should it be considered completely outdated?
1. Bacelieri R, Johnson SM. Cutaneous warts: an evidence-based approach to therapy. Am Fam Physician 2005;72:647-52.
in reply: The letters from Dr. Monjok and Dr. Viel made excellent points, and I would like to address each one separately.
In response to Dr. Monjok's question of whether surgical excision is still a viable option for warts: Surgical excision for warts is impractical as a cure because cutaneous warts are caused by a virus that often exists on normal appearing skin outside of the confines of the clinical wart. On multiple occasions, I have seen a "doughnut wart" or clinical wart around a surgical site. With that information, it is still a worthwhile practice to debulk a large clinical wart to improve patient comfort in areas of the world where more effective treatments are unavailable.
In reply to Dr. Viel, duct tape occlusion is an effective treatment for warts, as noted in the study by Focht and colleagues.1 In my practice, I often use over-the-counter salicylic acid or prescription 40 percent urea gel under occlusion with duct tape for plantar warts. I personally find it difficult to use duct tape for common warts on other locations.
1. Focht DR III, Spice C, Fairchok MP. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med 2002;156:971-4.
Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: email@example.com, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.
Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
Copyright © 2005 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions