Shimizu Akira, Mieko Kosaka, Yamaguchi Kayoko, Niwa Osamu, Ishigaki Yasuhito, Sakurai Masaru
Department of Dermatology, Kanazawa Medical University, Kanazawa, Ishikawa, Japan.
Diagnostics Division, Maruho Co., Ltd., Osaka, Japan.
J Dermatol. 2025 Jan;52(1):175-178. doi: 10.1111/1346-8138.17497. Epub 2024 Oct 7.
Cutaneous warts are caused by human papillomavirus (HPV) infection. Distinguishing plantar warts from clavus and tylosis can be difficult. A less-invasive method of examining these lesions is necessary. Previously, we collected data on 90 patients with warts and related diseases to explore differentiation methods using HPV typing of tissue from the wart surface. In that study, 21 patients were diagnosed as cases with plantar warts, however, 10 of those 21 cases showed HPV-negative by polymerase chain reaction analysis, causing some ambiguity, thus their outcomes should be confirmed. To assess the role of HPV typing in clinical practice, we followed up these 21 cases (11 HPV-positive and 10 HPV-negative) and analyzed their outcomes. The HPV-positive group included HPV1a (one case), HPV27 (four cases), HPV57 (three cases), and HPV65 (three cases). The median age of the 21 patients was 43 years, that of the 11 HPV-positive cases was 37 years, and that of the 10 HPV-negative cases was 44 years. The sex ratios (male:female) of the HPV-positive and HPV-negative groups were 6:5 and 2:8, respectively. All 21 patients were treated with liquid nitrogen after surface keratin removal, concomitant with salicylic acid topical plaster or oral administration of Yokuinin. The longest follow-up period was 548 days. Kaplan-Meier analysis was performed to assess the healing rate according to HPV-positivity. The healing rate in HPV-positive cases was significantly higher than in HPV-negative cases (P = 0.001). Although the sample size was small, the results suggest HPV typing using non-invasive surface materials facilitates accurate diagnosis and prevents prolonged treatment of plantar warts.
皮肤疣由人乳头瘤病毒（HPV）感染引起。区分跖疣与鸡眼和胼胝可能会很困难。因此需要一种侵入性较小的方法来检查这些病变。此前，我们收集了90例疣及相关疾病患者的数据，以探索利用疣表面组织的HPV分型进行鉴别诊断的方法。在该研究中，21例患者被诊断为跖疣，但这21例中有10例经聚合酶链反应分析显示HPV阴性，这造成了一些不确定性，因此其结果应予以确认。为评估HPV分型在临床实践中的作用，我们对这21例患者（11例HPV阳性和10例HPV阴性）进行了随访并分析其结果。HPV阳性组包括HPV1a（1例）、HPV27（4例）、HPV57（3例）和HPV65（3例）。21例患者的中位年龄为43岁，11例HPV阳性患者的中位年龄为37岁，10例HPV阴性患者的中位年龄为44岁。HPV阳性组和阴性组的性别比（男∶女）分别为6∶5和2∶8。所有21例患者在去除表面角质后均采用液氮治疗，并辅以水杨酸外用贴膏或口服薏苡仁。最长随访期为548天。采用Kaplan-Meier分析评估HPV阳性情况的愈合率。HPV阳性病例的愈合率显著高于HPV阴性病例（P = 0.001）。尽管样本量较小，但结果表明，使用非侵入性表面材料进行HPV分型有助于准确诊断并避免跖疣的长期治疗。
