Cryotherapy vs trichloroacetic acid 90% in treatment of common warts.

INTRODUCTION: Common warts are hyperkeratotic, benign cutaneous growths caused by types 1, 2, and 7 Human papilloma viruses. Different modalities are available to treat warts. Cryotherapy is one of the most common and effective treatments for common warts. Trichloroacetic acid (TCA), in high concentrations, can be used as a therapeutic modality. OBJECTIVES: The aim of this study is to compare the efficacy and safety of cryotherapy using liquid nitrogen (spray method) versus trichloroacetic acid 90% in treatment of common warts. PATIENTS AND METHODS: Thirty-five patients with 414 common warts, from the Dermatology outpatient clinic, Assiut University Hospital, were enrolled in this study. We used two techniques for the treatment of common warts. The lesions in each patient were divided into two groups (A and B), group A treated by cryotherapy while group B treated by trichloroacetic acid (TCA) 90%. RESULTS: There was significant decrease in the size of the warts in both groups. There were statistically significant better results among group A than group B regarding the mean percentage of improvement (90.11 ± 27.92 vs 26.19 ± 42.93, respectively; P < 0.001) and grade of improvement, where good response was obtained in 89.2% in group A compared with 26.2% in group B (P < 0.001). Complete cure was significantly higher in group A (83.1%) than group B (21.3%; P < 0.001). However, side effects were significantly higher among group A than group B. CONCLUSION: Cryotherapy is more effective than TCA 90% in treatment of common wart. TCA 90% has lesser complications than cryotherapy.

Trichloroacetic Acid Versus Salicylic Acid in the Treatment of Acne Vulgaris in Dark-Skinned Patients.

BACKGROUND: Treatment options for acne include chemical peeling. Trichloroacetic acid (TCA) has been used for treating acne. The ability of TCA to diminish corneocyte cohesion and keratinocyte plugging addresses this mode of treatment. Salicylic acid is an excellent keratolytic agent. It is believed to function through solubilization of intercellular cement, thereby reducing corneocyte adhesion. OBJECTIVE: Comparing the therapeutic efficacy of TCA 25% peels with those of salicylic acid 30% in patients with acne vulgaris. MATERIALS AND METHODS: Twenty patients, Fitzpatrick skin Types III to V with facial acne, were enrolled. Twenty-five percent of TCA was applied to the right half of the face and 30% salicylic acid to the left half at 2-week interval for 2 months. RESULTS: Total improvement was more frequent with salicylic acid peeling (95%) versus (85%) with TCA. Total comedones improvement was more frequent with TCA peeling (80%) versus (70%) with salicylic acid. Improvement of inflammatory lesions was more frequent among the side treated with salicylic acid (85%) versus (80%) with TCA peeling. However, the results did not reach the statistical significance level. CONCLUSIONS: Trichloroacetic acid is more superior in treating comedonal lesions, whereas salicylic is more superior in treating inflammatory lesions, without significant different between their results.