Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Fam Pract. 2010 Oct;27(5):549-53. doi: 10.1093/fampra/cmq047. Epub 2010 Jul 7.
GPs apply several treatments for patients with cutaneous warts. Available evidence recommends salicylic acid application.
We investigated whether current choices of GPs in the treatment of warts are in agreement with available evidence.
A nationwide random sample of 700 Dutch GPs received a postal questionnaire on their choices in the treatment of warts. In addition, factors that influence these choices, their view on the effectiveness of treatments and their view on the natural history of warts were assessed.
The questionnaire was returned by 280 GPs (40%). Cryotherapy was first choice treatment in 73% of GPs for hand warts, 49% of GPs for plantar warts and 72% of GPs for warts on other locations. Salicylic acid application or the combination of cryotherapy and salicylic acid were used less frequently, followed by an expectant awaiting policy and (electro) surgery. Most important factors influencing their treatment choice were GPs' routine and GPs' views on effectiveness.
In contrast to available evidence, most GPs apply cryotherapy as first choice treatment of cutaneous warts. Pragmatic high-quality trials on the effectiveness of wart treatments conducted in primary care might solve this discrepancy between evidence and practice.
全科医生为患有皮肤疣的患者提供了几种治疗方法。现有证据推荐使用水杨酸制剂。
我们调查了全科医生目前对疣的治疗选择是否与现有证据一致。
对 700 名荷兰全科医生进行了一项全国范围内的随机抽样调查，以了解他们在治疗疣方面的选择。此外，还评估了影响这些选择的因素、他们对治疗效果的看法以及对疣自然史的看法。
280 名全科医生（40%）回复了调查问卷。冷冻疗法是 73%的全科医生治疗手部疣、49%的全科医生治疗足底疣和 72%的全科医生治疗其他部位疣的首选治疗方法。水杨酸制剂或冷冻疗法和水杨酸制剂联合应用的频率较低，其次是等待自然消退的观望政策和（电）手术。影响他们治疗选择的最重要因素是全科医生的常规治疗和对疗效的看法。
与现有证据相反，大多数全科医生将冷冻疗法作为治疗皮肤疣的首选方法。在初级保健中进行的关于疣治疗效果的实用高质量试验可能会解决这一证据与实践之间的差异。
