ORAL ZINC SULPHATE VS. TOPICAL APPLICATION OF SALICYLIC (16.7%) & LACTIC ACID (16.7%) COMBINATION IN THE TREATMENT OF PLANTAR WARTS
Warts are commonly acquired viral tumors, caused by Human Papilloma Virus (HPV). This virus can infect and cause disease at any site in the stratified squamous epithelium either keratinizing or non-keratinizing. A plantar wart (also called verruca plantaris) is a lesion that appears on the plantar surface of foot as a small, shining, sago-grain papule which soon assumes the typical appearance of a sharply-defined rounded lesion with a rough keratotic surface, surrounded by a smooth collar of thickened horn.
To compare the efficacy and safety of oral zinc sulphate versus topical application of salicylic (16.7%) & lactic acid (16.7%) combination, in the treatment of plantar warts.
Comparative interventional study.
Setting and Duration of Study:
Department of Dermatology Unit-I, King Edward Medical University, Mayo Hospital Lahore, from 15 February, 2009 till 14 February, 2010.
After informed consent, one hundred patients of plantar warts were selected from the outpatient Department of Dermatology, Mayo Hospital, Lahore. The patients were divided into two equal groups; in group A, 50 patients were given oral zinc sulphate (10 mg/kg/day) in two or three divided doses and in group B, 50 patients were advised to apply a combination of salicylic (16.7%) & lactic acid (16.7%) once at night daily. In group A, using oral zinc sulphate, the treatment was given for two months and follow up continued for next 4 months. In group B, the topical preparation was also continued for 2 months or till the complete removal of wart (if before two months) and follow up was extended up to 4 months after treatment.
The mean age of patients in group A was 26.2 ± 8.1 years and in group B 26.3 ± 7.3 years. The mean number of warts in group A was 7.9 ± 3.5 and in group B 5.7 ± 2.6. The mean duration of disease in group A was 6.9 ± 4.1 months and in group B 6.0 ± 3.9 months. On follow up at 2nd month, in group A, 41 (82%) patients showed an excellent efficacy while 9 (18%) patients observed poor efficacy. In group B, 31 (62%) cases experienced an excellent response, 2 (4%) had a good efficacy and 17 (34%) patients showed a poor efficacy. At 4th month of follow-up, no recurrence of warts was seen in both groups in complete responders. On follow up of the non responders no furthure clearance of warts was observed.
It was concluded from this study that oral zinc sulphate is significantly more effective (p-value <0.05) than topical application of salicylic (16.7%) and lactic acid (16.7%) combination in the treatment of plantar warts.
Plantar warts, oral zinc sulphate, salicylic acid, lactic acid
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