Podiatry-1 5 Warts Treatment by 810nm Diode Laser
The present work was done in an attempt to build systematic procedures for treating warts by 810 nm diode laser regarding dose parameters, application parameters and laser safety. The study was done in Al- Kindy Teaching Hospital in Baghdad, Iraq during the period from 1st October 2003 till 1st April 2004. Fifteen patients completed the treatment and they were followed for the period of 3 months. Recalcitrant and extensive warts were selected for the study. Patients were randomly divided into 3 groups to be treated by different laser powers 9, 12 and 15 W, power density of 286 W/cm2, 381W/cm2, 477 W/cm2 pulse duration of 0.2 s, interval of 0.2 s and repeated pulses were used. The mode of application was either circular or radial. Pain occurred for about 1 week after treatment especially on movement (when lesions near joint) to all group and power density. Oozing occurred from lesion with scales and oedema after laser treatment for about 1 week. Post-inflammatory hypo-pigmentation might occur after the lesion have healed completely. No recurrence of lesions after complete healing of lesions. Complete healing of the lesion was noticed, no scarring after complete healing of lesion. Diode laser therapy of recalcitrant and extensive viral warts could be considered as a valuable alternative to other more traditional techniques. This treatment can offer a good result in eliminating the verrucae and their sequelae of recurrence, scarring and the post-operative pain.
Viral warts are benign epidermal neoplasms caused by human papillomas virus infection. Individual variations in cell-mediated immunity may explain differences in severity and duration of warts (Habif, 1996). Warts occur in normal people and persist for prolonged periods, sometimes many years. These may be a source of considerable discomfort and embarrassment to the patients. Various conventional treatments have been employed to deal with these lesions. The treatment included destructive techniques such as curettage, electrocautery, surgical excision, and cryotherapy. Immunostimulation like levamisol, cimetidene, and dinitrochlor-benzene sensiti-zation, virucidal agents like glutaraldehyde or formaldehyde, and the use of intralesional agents such as bleomycin or interferon-a (Shelley and Shelley; 1991; Wilkinson, 1998). Warts that fail to respond to conventional treatment have been considered as recalcitrant. In the last years, there are many reports from different areas of the world concerning the use of the CO2 laser (Wheeland and Walker, 1986), pulsed dye laser (Kauvar etal., 1995), copper vapor laser (Nemeth and Hpudek, 1991). The present work was done in an attempt to build a systematic procedure for treating warts by diode laser regarding dose parameters, application parameters and laser safety.