BACKGROUND: Verruca vulgaris (VV) is a common viral disease in children. Treatment options are often not well-tolerated in children due to pain or adverse effect risk. Nonthermal atmospheric plasma (NTAP), which generates reactive oxygen/nitrogen species, is well-tolerated and without adverse effects.
OBJECTIVE: Determine efficacy of NTAP as compared to standard of care (SOC) therapy for VV in children.
METHODS: This prospective open-label study randomized lesions 1:1 to receive NTAP or SOC (cryotherapy). Patients were treated at 4-week intervals for a maximum of 3 treatments. They were evaluated four weeks post-final treatment for sustained response. Primary outcome was lesion response.
RESULTS: 112 VV lesions in 14 patients were enrolled. Patients were mostly white (92.9%) males (71.4%) with mean age of 9.5 [±2.5] years. Responses of SOC- and NTAP-treated lesions respectively included: no response (5.4%, 7.1%); partial response (33.9%, 41.1%); and complete resolution (60.7%, 51.8%; p-value=0.679). Patients were more likely to report pain in SOC lesions post-treatment (p-value<0.001). No significant adverse events (AEs) occurred.
CONCLUSIONS: Limitations include single-site, maximum of three treatments, and short post-treatment follow-up.
CONCLUSIONS: NTAP is an efficacious, safe intervention for treatment of VV in children.

BACKGROUND: The clinical strategy of oral supplementation of Vitamin D (VD) as a preventive and therapeutic measure for warts needs further exploration.
METHODS: The clinical data of patients with skin diseases who visited the Children\'s Hospital affiliated with Chongqing Medical University from February 2018 to June 2024 were collected. The serum VD levels in patients with warts (common warts, flat warts, and plantar warts) and patients with other common skin diseases (atopic dermatitis, psoriasis, alopecia areata, vitiligo, and chronic urticaria) were compared. Two-sample bidirectional Mendelian randomization (MR) analysis was performed to investigate potential causal associations between VD and warts.
RESULTS: The average serum VD level of children with warts was 23.27 ± 7.07 ng/mL, which showed no statistically significant difference compared to children with other common skin diseases. The inverse variance weighted (IVW) method analysis indicated a positive causal relationship between VD and warts (Odds Ratio [OR] = 1.86, [95% CI: 1.19-2.92], p = 0.007). Sensitivity analysis did not show any indication of horizontal pleiotropy or heterogeneity. The MR-PRESSO method did not identify any outliers.
CONCLUSIONS: The levels of serum VD in children with warts do not significantly decrease compared to children with other common skin conditions. The evidence from the MR analysis indicates a positive causal relationship between VD and warts, suggesting caution in supplementing VD for children with warts who have normal or elevated serum VD levels. Further clinical studies are needed for validation in the future.

Human papillomavirus (HPV) vaccination represents a milestone in primary prevention of sexually transmitted infections. However, little is known about its possible effects on already established HPV infections. We report the case of a 9-year-old immunosuppressed girl with refractory warts, successfully treated with the nonavalent-HPV vaccine and review the literature about the therapeutic effects of HPV vaccination on benign HPV-induced epithelial proliferations in immunocompetent and immunosuppressed patients. In the literature, promising results were shown on cutaneous warts after HPV vaccination, especially in children and young adults, also in immunosuppressed patients, whereas controverse results were found on anogenital warts. These findings suggest a critical need for randomized clinical trials to assess the efficacy of HPV vaccination in the treatment of benign HPV-induced epithelial proliferations.

There are many therapeutic modalities for plantar warts, however treating it remains challenging. Intralesional injection of 5-fluorouarcil and combined digoxin and furosemide were observed to be effective and safe, however no comparison study between them was done. Our study was conducted to evaluate the efficacy of both therapies in the treatment of plantar warts. 90 adult patients with multiple recalcitrant plantar warts were included in our study. They were randomly allocated to one of three groups; combined digoxin and furosemide, 5-fluorouarcil, or normal saline group. Fortnightly injections were done into all studied warts till complete clearance or up to 5 sessions. Warts were evaluated clinically and dermoscopically. Clinical response was reported in 24 patients (80%) of the combined digoxin and furosemide group with 40% complete response and in 24 patients (80%) of the 5-fluorouarcil group with 33.3% complete response. No statistically significant difference was observed between the two groups concerning efficacy and safety. Intralesional injection of 5-fluorouarcil and combined digoxin and furosemide are nearly equivalent in efficacy and safety for plantar wart treatment. Dermoscopy helps to take the truthful judgment about complete clearance of warts.

OBJECTIVE: To determine variations in allele and genotype frequencies between keratoacanthoma (KA) and common warts (CW), compared with the control group, in three single nucleotide polymorphisms (SNPs) within the TLR2, TLR3, and TLR9 genes.
METHODS: This case-control study involved samples from 161 patients with KA, 152 patients with CW, and 469 controls. DNA was isolated from formalin-fixed paraffin-embedded tissue sections. Three SNPs - rs4696480 in TLR2, rs7657186 in TLR9, and rs35213 in TLR3 - were genotyped with TaqMan Genotyping Assays on the 7500 Real-Time PCR System.
RESULTS: TLR2 rs4696480 and TLR3 rs7657186 were significantly overrepresented in KA and CW compared with controls (P<0.001). The association was stronger for CW than for KA, as evidenced by higher frequencies of the A allele and AA genotype for rs4696480. Both KA and CW patients had higher frequencies of the G allele and GG genotype for rs7657186 than controls. rs7657186 was moderately associated with KA and CW, with the G allele and GG genotype being more prevalent in CW cases, where no AA homozygotes were found.
CONCLUSIONS: Genetic variants in TLR2 (rs4696480) and TLR3 (rs7657186) genes may affect KA and CW development, influencing immune responses and susceptibility to these skin lesions. Further research is required to elucidate TLR expression patterns and their role in KA development.

OBJECTIVE: To observe the clinical effect of modified fire-needle technique and herbal bathing-repairing therapy of TCM on multiple verruca plantaris.
METHODS: Seventy patients with multiple verruca plantaris were randomly divided into an observation group (35 cases, 1 case was eliminated) and a control group (35 cases, 2 cases dropped out). In the control group, the herbal bathing-repairing therapy of TCM was adopted. In the observation group, besides the treatment as the control group, fire needling and cauterization were delivered on the base of skin lesion or the sites with rich blood vessels under the dermoscope. The intervention was provided once a week, one course of treatment was composed of 3 weeks, and two courses were required in each group. The score of the self-designed symptom scale, the score of dermatology life quality index (DLQI) and the area of typical skin lesion were observed before and after treatment. The clinical effect was evaluated after treatment and the recurrence was assessed 2 months after treatment completion in the two groups.
RESULTS: After treatment, the scores of the self-designed symptom scale and DLQI were lower and the area of typical skin lesion was smaller compared with those before treatment in the two groups (P<0.05). The scores of the self-designed symptom score and DLQI in the observation group were reduced (P<0.05), and the area of typical lesion was smaller (P<0.05) in comparison with those in the control group. The total effective rate was 91.2% (31/34) in the observation group, higher than that in the control group (60.6%, 20/33, P<0.05). The recurrence rate was 6.5% (2/31) in the observation group, lower than that in the control group (35.0%, 7/20, P<0.05).
CONCLUSIONS: Modified fire-needle technique combined with herbal bathing-repairing therapy ameliorates clinical symptoms and the quality of life in the patients with multiple verruca plantaris and reduces the recurrence of the disease.
目的：观察改良火针技术联合中医修治疗法治疗多发性跖疣的临床疗效。方法：将70例多发性跖疣患者随机分为观察组（35例，剔除1例）和对照组（35例，脱落2例）。对照组采用中医修治疗法治疗；在对照组的基础上，观察组在皮肤镜引导下于皮损基底部或血供富集处行火针烙刺。两组治疗均每周1次，3周为一疗程，共治疗2个疗程。分别于治疗前后观察两组患者自拟症状评分、皮肤病生活质量指数（DLQI）评分、典型皮损面积。于治疗后评定两组临床疗效，治疗后2个月评估两组复发情况。结果：治疗后，两组患者自拟症状评分和DLQI评分较治疗前降低、典型皮损面积较治疗前缩小（P<0.05），观察组自拟症状评分和DLQI评分低于对照组、典型皮损面积小于对照组（P<0.05）。观察组总有效率为91.2%（31/34），高于对照组60.6%（20/33，P<0.05）。观察组复发率为6.5%（2/31），低于对照组的35.0%（7/20，P<0.05）。结论：改良火针技术联合中医修治疗法可改善多发性跖疣患者临床症状及生活质量，降低跖疣复发率。.

Treating plantar warts is still a challenging problem with a long list of diverse treatment options that none of them seems to be definitive. To evaluate the effectiveness of intralesional acyclovir versus intralesional Hepatitis-B vaccine (HBV) in treatment of multiple resistant plantar warts. Forty-eight patients with resistant plantar warts completed the study with no dropouts. They were randomized into 3 groups; group(A) receiving intralesional HBV, group (B) receiving intralesional acyclovir and group (C) receiving intralesional saline as a control group over 5 biweekly sessions or until wart clearance. Clinical outcome was assessed through sequential digital lesion photographing upon each visit. Treatment related adverse reactions were recorded. 43.8%, 37.5% & 18.7% of Groups A, B &C respectively showed a complete response. pain was obvious in 100% and 56.3% of cases receiving intralesional acyclovir and HBV respectively. Up to the 6 month follow up period, none of the complete responders in all groups returned with a recurrence. Both acyclovir and HBV showed comparable efficacy and seem to be promising options for treating plantar warts being safe, affordable, and theoretically safe in immunocompromised cases.

Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the diverse number of treatments available. Therapies targeting vasculature, such as pulsed dye laser, have been used successfully in the treatment of plantar warts. Polidocanol, a detergent sclerosant approved for the sclerotherapy of incompetent and dilated saphenous veins, has also been used as an off-label therapy for a wide range of skin conditions with vascular components such as hemangiomas and pyogenic granuloma. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional polidocanol 3% in the treatment of plantar warts. Twenty patients (11 females and 9 males), with plantar warts, aged 12-50 years received biweekly sessions of intralesional polidocanol 3% until complete clearance or for a maximum of 6 sessions. Response to treatment was graded as complete (100% clearance), partial (50-99%), and no response (< 50%). At the end of the study, 12 (60%) patients achieved complete clearance of their warts after 1-5 sessions, 5 (25%) patients had only partial response, and 3 (15%) patients did not achieve any clearance of their warts. The procedure was largely tolerable by patients. Pain at the injection site and bruises were reported by 9 (45%) and 2 (10%) patients, respectively. Both side effects resolved spontaneously and completely within a few days. The findings of the current study suggest that intralesional injection of 3% polidocanol in biweekly sessions may be a safe, effective, and tolerable method for the treatment of plantar warts.

UNASSIGNED: We investigated efficacy and safety of mavorixafor, an oral CXCR4 antagonist, in participants with warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome, a rare immunodeficiency caused by CXCR4 gain-of-function variants. This randomized (1:1), double-blind, placebo-controlled, phase 3 trial enrolled participants aged ≥12 years with WHIM syndrome and absolute neutrophil count (ANC) ≤0.4 × 103/μL. Participants received once-daily mavorixafor or placebo for 52 weeks. The primary end point was time (hours) above ANC threshold ≥0.5 × 103/μL (TATANC; over 24 hours). Secondary end points included TAT absolute lymphocyte count ≥1.0 × 103/μL (TATALC; over 24 hours); absolute changes in white blood cell (WBC), ANC, and absolute lymphocyte count (ALC) from baseline; annualized infection rate; infection duration; and total infection score (combined infection number/severity). In 31 participants (mavorixafor, n = 14; placebo, n = 17), mavorixafor least squares (LS) mean TATANC was 15.0 hours and 2.8 hours for placebo (P < .001). Mavorixafor LS mean TATALC was 15.8 hours and 4.6 hours for placebo (P < .001). Annualized infection rates were 60% lower with mavorixafor vs placebo (LS mean 1.7 vs 4.2; nominal P = .007), and total infection scores were 40% lower (7.4 [95% confidence interval [CI], 1.6-13.2] vs 12.3 [95% CI, 7.2-17.3]). Treatment with mavorixafor reduced infection frequency, severity, duration, and antibiotic use. No discontinuations occurred due to treatment-emergent adverse events (TEAEs); no related serious TEAEs were observed. Overall, mavorixafor treatment demonstrated significant increases in LS mean TATANC and TATALC, reduced infection frequency, severity/duration, and was well tolerated. The trial was registered at www.clinicaltrials.gov as #NCT03995108.

UNASSIGNED: Extragenital warts, often known as EGWs, affect between 7% and 10% of the population. Despite the plethora of research on the impact of genital warts (GWs) on \"Quality Of Life\", EGWs have received little attention. The purpose of this study was to conduct a cross-sectional investigation with the objective of contrasting the effects of GWs and EGWs on the health-related quality of life and other characteristics.
UNASSIGNED: A cross-sectional clinical study was piloted at a tertiary care center. Participants in the study included two groups of healthy adults, each group consisting of 100 adult subjects. Those diagnosed with EGWs were included in group A, while patients diagnosed with GWs made up group B. The \"Dermatology Life Quality Index\" questionnaire was used to evaluate various parameters. Observations were compared for significance.
UNASSIGNED: The majority of the subjects in both the groups were observed to have less than 10 warts. The Dermatology Life Quality Index score for the EGWs had an average of 8.66 ± 2.31 score; GWs had an average of 5.12 ± 3.25. This mean variance was statistically significant. The level of the dissatisfaction was highly significantly different among the groups and the subjects being more in the EGW group dissatisfied.
UNASSIGNED: The findings of this investigation indicate that EGWs have a significant and detrimental effect on the Quality Of Life. Medical experts must teach people how to prevent the disease\'s spread and recurrence due to its persistence. They must also consider the psychological and societal repercussions of the disease while discussing therapy choices.