ABSTRACT
Background: Cutaneous warts are self-limited but can persist and increase in size and number. Palmoplantar and periungual warts are difficult to treat. Many local treatments are used for warts including immunotherapy using mumps, candida, and trichophyton skin test antigen. Objective: To determine the effect of immunotherapy with tuberculin PPD for palmoplantar and periungual warts. Methods: Intralesional tuberculin PPD was injected into the same lesion every two weeks until the lesion disappeared. Results: We studied 42 patients, 21 patients under 15 years old. The number of warts was from one to more than 20; 23 patients had more than one lesion. Forty patients (93%) were in remission. The lesion disappeared in 14%, 38%, 64%, 71%, 81%, and 93% after 1, 2, 3, 4, 5, and 6 treatments, respectively. In patients with multiple warts, lesions that were not treated also disappeared in 20 out of 23 patients (87%). Three patients had edema and erythema on the injected sites. Other three patients had painful purpura at the site of injection. During at least six months follow-up, one patient had new lesions, which were again effectively treated with tuberculin PPD. Conclusion: Intralesional tuberculin PPD was effective in treatment of cutaneous palmoplantar and periungual warts. It is a simple procedure, not very painful, and may be used as an alternative treatment for cutaneous palmoplantar warts, especially in multiple warts.
ABSTRACT
<p><b>INTRODUCTION</b>This study evaluated the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis (AD).</p><p><b>MATERIALS AND METHODS</b>A questionnaire survey of 255 dermatologists in Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam.</p><p><b>RESULTS</b>Familiarity with diagnostic criteria varied considerably. The usage of moisturisers by the respondents from Vietnam and Indonesia was significantly less frequent than the other countries. Most respondents (91% to 100%) used topical corticosteroids in children with mild-to-moderately severe dermatitis. Some respondents in the Philippines (17% to 19%) and Vietnam (11% to 25%) only used topical corticosteroids for severe disease. For infected eczema, most respondents would prescribe systemic antibiotics for mild-to-moderate infection. A minority in the Philippines (14%) and Vietnam (11%) did so only for severe infection. The top 4 systemic antibiotics prescribed most frequently were: erythromycin, cloxacillin, cephalosporin and amoxicillin/clavulanic acid. In Indonesia, a large proportion of the respondents (47%) prescribed amoxicillin most frequently. The majority of respondents (60% to 100%) prescribed both sedating and non-sedating oral antihistamines. Most respondents used oral corticosteroids to treat severe AD. Some in Malaysia, Singapore and Vietnam used cyclosporin (7% to 58%), azathioprine (5% to 31%) and methotrexate (5% to 14%). With the exception of those in Singapore, the majority of respondents (71% to 97%) did not use phototherapy.</p><p><b>CONCLUSION</b>Familiarity with diagnostic criteria, the early and judicious use of moisturisers and topical corticosteroids, as well as the treatment of Staphylococcus aureus superinfection with penicillinase-stable antibiotics should be emphasised in this region.</p>