Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.
Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
J Eur Acad Dermatol Venereol. 2023 Dec;37(12):2569-2574. doi: 10.1111/jdv.19388. Epub 2023 Aug 9.
Viral warts are common infectious skin disease induced by human papillomavirus (HPV). Lasers have been used for warts treatment in recent years with variable success rates.
This study aimed to prospectively evaluate combined treatment with Er:YAG laser and long-pulsed Nd:YAG laser compared to Er:YAG laser for the treatment of recalcitrant warts after one session.
This study included 240 lesions from 24 patients. All the lesions were diagnosed clinically as recalcitrant warts after failure of topical treatment and cryotherapy. About 120 lesions underwent a combined therapy of Er:YAG and long-pulsed (LP) Nd:YAG lasers, and the remaining 120 lesions underwent Er:YAG laser therapy only. The clearance rate was evaluated 5 weeks after and classified by three-graded evaluation: complete response, partial response and poor response.
The clearance rate in the combined Er:YAG + LP Nd:YAG lasers group was, statistically significant, higher than that of the Er:YAG laser group (p = 0.008). The complete response rate was 48% (58 of 120 warts) for the Er:YAG +LP Nd:YAG lasers group and only 29% (35 of 120 warts) for the Er:YAG laser group.
The combination of Er:YAG and long-pulsed Nd:YAG lasers is more effective than Er:YAG laser alone in treating recalcitrant warts after single session.
病毒疣是由人乳头瘤病毒（HPV）引起的常见传染性皮肤病。近年来，激光已被用于治疗疣，成功率不一。
本研究旨在前瞻性评估联合应用 Er:YAG 激光和长脉冲 Nd:YAG 激光与单独应用 Er:YAG 激光治疗一次后难治性疣的疗效。
本研究纳入了 24 例患者的 240 处病变。所有病变均经临床诊断为局部治疗和冷冻治疗失败后的难治性疣。120 处病变接受 Er:YAG 和长脉冲（LP）Nd:YAG 激光联合治疗，其余 120 处病变仅接受 Er:YAG 激光治疗。在治疗后 5 周评估清除率，并通过三级评估进行分类：完全缓解、部分缓解和差反应。
联合应用 Er:YAG + LP Nd:YAG 激光组的清除率明显高于单独应用 Er:YAG 激光组（p=0.008）。Er:YAG + LP Nd:YAG 激光组的完全缓解率为 48%（58/120 个疣），而 Er:YAG 激光组仅为 29%（35/120 个疣）。
单次治疗后，联合应用 Er:YAG 和长脉冲 Nd:YAG 激光比单独应用 Er:YAG 激光治疗难治性疣更有效。
