Dermatology Clinic, University of Catania, Catania.
Dermatol Ther. 2022 Jul;35(7):e15528. doi: 10.1111/dth.15528. Epub 2022 Apr 27.
During the COVID-19 pandemic, teledermatology services were set up and enhanced to take care of those benign conditions like cutaneous warts (CWs) which, if undiagnosed or treated with delay, could have worsened, enlarged, and potentially spread to the community. The aim of this hybrid exploratory trial was to combine face-to-face clinical and dermoscopic evaluation with teledermatology follow-up in the management of CWs with a cryogenic pen based on nitrous oxide for home treatment. Twelve adult patients affected by CWs were enrolled. During the first face-to-face visit, single CWs were selected for the study by clinical and dermoscopic evaluation. The home schedule consisted of one application to be repeated after 2 weeks, when signs of CWs were still evident. Patients were also asked to send a clinical photo of the treated lesion at weekly intervals. A final face-to-face evaluation was scheduled to verify the response to home treatment by clinical and dermoscopy evaluation. A total of 20 CWs located on the trunk and the extremities were treated: a complete clinical and dermoscopic resolution was observed in 16 out of 20 lesions (80%), and a partial response in two cases. The adverse events observed during treatment were comparable to those normally observed with cryotherapy of CWs. In conclusion, home treatment of CWs with the cryogenic pen, that should be always preceded by dermatologist diagnosis and prescription, is safe and effective, especially if combined with face-to-face and teledermatology consultations, pointing out its important role during pandemic times or in any other environmental limitations that may impair the access to medical care services. The combination of face-to-face consultations for initial and final visits and teledermatology during the treatment phase could represent a model for other dermatologic conditions as well (e.g., acne, rosacea, psoriasis, atopic eczema etc.).
在 COVID-19 大流行期间，设立并加强了远程皮肤病学服务，以治疗皮肤疣（CWs）等良性疾病。如果未及时诊断或治疗，这些疾病可能会恶化、扩大，并有可能传播到社区。本混合探索性试验旨在将面对面的临床和皮肤镜评估与基于一氧化二氮的冷冻笔的远程皮肤病学随访相结合，用于管理家用 CWs。共招募了 12 名患有 CWs 的成年患者。在首次面对面就诊时，通过临床和皮肤镜评估选择单个 CWs 进行研究。家庭治疗方案包括在 2 周后重复一次治疗，当 CWs 的迹象仍然明显时。还要求患者每隔一周通过临床照片发送治疗病变的情况。最后一次面对面评估旨在通过临床和皮肤镜评估验证家庭治疗的反应。共治疗了位于躯干和四肢的 20 个 CWs：20 个病变中有 16 个（80%）完全临床和皮肤镜缓解，2 个部分缓解。治疗过程中观察到的不良事件与 CWs 冷冻治疗通常观察到的事件相当。总之，在皮肤科医生诊断和处方的前提下，使用冷冻笔进行 CWs 的家庭治疗是安全有效的，尤其是在结合面对面和远程皮肤病学咨询的情况下，这在大流行期间或任何可能影响医疗服务获取的其他环境限制期间，突显了其重要作用。在初始和最终就诊期间进行面对面咨询，并在治疗阶段进行远程皮肤病学咨询，可能也是治疗其他皮肤科疾病（例如痤疮、酒渣鼻、银屑病、特应性皮炎等）的一种模式。
