Zhao Sheng-Nan, Huo Wei, An Qian, Gao Tian-Wen, Yao Zhi-Rong, Zhang Jian-Zhong, Zhang Xue-Jun, Gu Heng, Wu Ri-Na, Lu Hong-Guang, Han Xiu-Ping, Zeng Fan-Qin, An Rong-Zhen, Ma Lei, Chen Hong-Duo, Qi Rui-Qun, Gao Xing-Hua
Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.
Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China.
Dermatol Ther. 2022 May;35(5):e15403. doi: 10.1111/dth.15403. Epub 2022 Mar 12.
Most plane warts are recalcitrant to treatment. Both cryotherapy and local hyperthermia have been applied to treat plane warts. However, no direct comparative study on their respective efficacy and safety has ever been performed. To assess the efficacy and safety of local hyperthermia at 43 ± 1°C versus liquid nitrogen cryotherapy for plane warts. Sequential patients with plane warts entered the study, either receiving cryotherapy or local hyperthermia therapy at the discretion of the patients and the recommendations of consultants. Cryotherapy with liquid nitrogen was delivered in two sessions 2 weeks apart, while local hyperthermia was delivered on three consecutive days, plus two similar treatments 10 ± 3 days later. The temperature over the treated skin surface was set at 43 ± 1°C for 30 min in each session. The primary outcome was the clearance rates of the lesions 6 months after treatment. Among the 194 participants enrolled, 183 were included in the analysis at 6 months. Local hyperthermia and cryotherapy achieved clearance rates of 35.56% (48/135) and 31.25% (15/48), respectively (p = 0.724); recurrence rates of 16.67% (8/48) and 53.33% (8/15) (p = 0.01); and adverse events rates of 20.74% (28/135) and 83.33% (40/48), respectively (p < 0.001). Cryotherapy had a higher pain score (p < 0.001) and a longer healing time (p < 0.001). Local hyperthermia at 43°C and cryotherapy had similar efficacy for plane warts. Local hyperthermia had a safer profile than cryotherapy but it required more treatment visits during a treatment course. More patients preferred local hyperthermia due to its treatment friendly nature.
大多数扁平疣对治疗具有抵抗性。冷冻疗法和局部热疗均已应用于扁平疣的治疗。然而，尚未有关于它们各自疗效和安全性的直接对比研究。为评估43±1°C的局部热疗与液氮冷冻疗法治疗扁平疣的疗效和安全性。患有扁平疣的连续患者进入该研究，根据患者的选择和咨询人员的建议接受冷冻疗法或局部热疗。液氮冷冻疗法分两个疗程进行，间隔2周，而局部热疗连续进行三天，在10±3天后再进行两次类似治疗。每次治疗时，治疗皮肤表面的温度设定为43±1°C，持续30分钟。主要结局是治疗6个月后皮损的清除率。在纳入的194名参与者中，183名在6个月时纳入分析。局部热疗和冷冻疗法的清除率分别为35.56%（48/135）和31.25%（15/48）（p = 0.724）；复发率分别为16.67%（8/48）和53.33%（8/15）（p = 0.01）；不良事件发生率分别为20.74%（28/135）和83.33%（40/48）（p < 0.001）。冷冻疗法的疼痛评分更高（p < 0.001），愈合时间更长（p < 0.001）。43°C的局部热疗和冷冻疗法治疗扁平疣的疗效相似。局部热疗比冷冻疗法安全性更高，但在一个疗程中需要更多次就诊。由于其治疗的便利性，更多患者更喜欢局部热疗。
