Assessment of treatment of plantar warts.

THE treatment of plantar warts is occupying an increasing proportion of the time of dermatological externs. In Northern Ireland attendances of patients suffering from plantar warts at dermatological externs increased from 1,081 in 1962 to 1,267 in 1966, a rise of 17.2 per cent. Many treatments have been used: 1. Thomson (1943) first described the treatment of plantar warts by using 3 per cent formalin he cured 33 out of 39 patients. 2. Anderson and Shirreffs (1963) treated 192 cases of plantar warts with (a) formalin soaks; (b) plain water; (c) inert tablets by mouth. Over 60 per cent in each of these groups were cured. 3. Vickers (1961) used daily paring with 3 per cent formalin soaks applied for 15 minutes. In a survey of 646 patients, 80 per cent of all plantar warts were cured in six to eight weeks' treatment. 4. Rulison (1942) stated that warts have no specific treatment and also that cure was more probable in single than in multiple warts. 5. Duthie and McCallum (1951) using elastoplast alone cured 60 per cent of their cases. By combining elastoplast and podophyllin they had a higher percentage of cures. 6. Barr and Coles (1965) using (a) Nobecutane D; (b) 3 per cent formaldehyde in Nobecutane; (c) 6 per cent formaldehyde in Nobecutane, cured 47.8 per cent, 55.4 per cent and 58.7 per cent respectively in the three series treated. They eliminated at the first examination all cases in which they considered spontaneous cure would take place. This paper is an evaluation of treatment of patients with plantar warts seen at the Belfast City Hospital in 1966. The series can be divided easily into two parts: a. Patients referred to the Outpatient Department, Belfast City Hospital, by their own general practitioners. b. Patients referred to the Inpatient Department, Belfast City Hospital, by other dermatological externs. These patients were referred because operative removal of the warts under general anaesthesia was considered necessary. The first series comprise of 130 patients referred to the Outpatient Department, Belfast City Hospiial. Of these 130 patients, 17 did not attend at all and a further 22 lapsed after only one or two attendances. Eighty-three patients were treated by the following regime: 1. 5 per cent formalin to be applied as soaks to the warts for half an hour every evening. 2. The warts to be pared down every three days with a number 3 scalpel and number 15 blade. 3. The area surrounding the warts to be covered with a thin layer of Vaseline. 4. The warts to be kept covered with a wide strip of elastoplast.