psd-502 and Warts

Local anesthetic cream (LAC) has been used for analgesia in various procedures. However, the analgesic effect of LAC in cryotherapy for warts is unclear. We aimed to evaluate the effects of LAC in cryotherapy for warts.. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on the effects of LAC in cryotherapy for warts. We searched MEDLINE, CENTRAL, and EMBASE on 31 March 2017 for relevant RCTs. Two authors independently selected trials, assessed risk of bias, and extracted data. Disagreement was resolved by discussion with a third author.. We included three RCTs with 228 participants. Two included RCTs had a high risk of reporting bias, with one having a high risk of other bias as well. Use of LAC decreased the pain associated with cryotherapy for warts on the hardened skin of children (visual analogue scale, mean difference -20.80, 95 % confidence interval -40.71 to -0.89), but not in adults or on the nonhardened skin of either adults or children.. The available evidence does not support the routine use of LAC applied for ≤ 60 min in cryotherapy for warts.

Topics: Adult; Anesthetics, Local; Child; Cryotherapy; Humans; Lidocaine, Prilocaine Drug Combination; Pain Measurement; Randomized Controlled Trials as Topic; Warts

Cryotherapy using liquid nitrogen is an effective and commonly used treatment for palmoplantar warts. However, pain can be a limiting factor in the effective use of cryotherapy. In this study, we found that a single application of anesthetic cream following cryotherapy treatment of warts reduced posttreatment pain and led to improved tolerability of the procedure.

Topics: Adolescent; Anesthetics, Local; Child; Cryotherapy; Female; Humans; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Pain; Treatment Outcome; Warts; Young Adult

Cryotherapy with liquid nitrogen is an effective, safe and convenient form of treatment for plantar warts. EMLA® cream (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) is a topical local anaesthetic agent that has proven to be effective and well tolerated in the relief of pain associated with various minor interventions in numerous clinical settings.. In a single-centre, double-blind, randomised placebo-controlled study, 64 subjects were randomised into 2 groups. The subjects had a thick layer of EMLA® cream or placebo cream applied to pared plantar wart(s) and onto the surrounding margin of 1 mm to 2 mm under occlusion for 60 minutes prior to receiving cryotherapy. The pain of cryotherapy was evaluated by the subjects using a self-administered Visual Analogue Scale (VAS) immediately after the cryotherapy.. There was no statistical difference between the mean VAS score for EMLA® cream (47.0 ± 21.4 mm) and placebo (48.9 ± 22.0 mm). Those with more than 1 wart had a significantly higher VAS score than those with only 1 wart (59.1 ± 21.8 vs. 44.3 ± 20.4, P <0.05) but this did not affect the therapeutic effect of EMLA® cream prior to cryotherapy.. We conclude that the application of EMLA® cream prior to cryotherapy does not reduce the pain associated with cryotherapy.

Topics: Adult; Analgesia; Anesthetics, Local; Cryotherapy; Double-Blind Method; Female; Foot Dermatoses; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Ointments; Prilocaine; Warts; Young Adult

The analgesic effect of topical application of EMLA cream for the curettage verrucae vulgaris was compared to local infiltration with lignocaine in 89 patients. The main purpose of this randomized study was to evaluate the patients' overall impression of the treatment. All patients anaesthetized by lignocaine infiltration reported it as 'an acceptable procedure' compared to only 71% of the patients treated with EMLA. It cannot be recommended to use EMLA cream as local anaesthetic for curettage of verrucae vulgaris, presumably because the highly keratotic nature of the common warts does not allow sufficient penetration of epicutaneously applied EMLA.

Topics: Adolescent; Adult; Anesthetics, Local; Child; Curettage; Drug Combinations; Female; Humans; Injections; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Ointments; Pain Measurement; Prilocaine; Warts

To compare analgesic efficacy and pain caused by administration of lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for punch biopsy and electrocoagulation of genital warts in men.. Open randomised comparative parallel-group study.. Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands.. 63 males with warts on the genital mucosa and/or perianal area.. EMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery. Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during administration and surgery was assessed by the patient on a verbal rating scale and on a visual analogue scale.. EMLA(R) application was painless in all patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29 patients and moderately painful in 10/29 patients. EMLA(R) analgesia was satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine infiltration was satisfactory in all procedures.. EMLA(R) application on the male genital mucosa is painless but it has a lower analgesic efficacy than xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies in this area and may be used as premedication for local infiltration.

Topics: Adolescent; Adult; Aged; Anesthesia, Local; Anesthetics, Local; Biopsy; Drug Combinations; Electrocoagulation; Genital Diseases, Male; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Pain Measurement; Prilocaine; Warts

Removal of genital warts by thermocautery was performed in 108 patients (57 men and 51 women) under topical anaesthesia with a local anaesthetic cream, lidocaine and prilocaine (EMLA). Most men had warts in the preputial cavity, most women had warts situated on the mucous membranes of the vulva, and warts at multiple sites were common. About 1 ml of cream per lesion was applied to the warts for 20 to 105 minutes before the operation. Plastic film (Glad, Union Carbide) was applied over the cream when natural occlusion, such as under the prepuce or on the introitus, was not present. Local pallor was seen in 30% of the patients, redness in 53%, and oedema in 15%, but did not cause any discomfort and were clinically insignificant. Analgesia was sufficient in 96% of the men and in 40% of the women. Additional local infiltration was given to 60% of the women, but was not as painful as injections generally are in the genital area. The analgesic efficacy on women may be further improved by optimising the application time on the genital mucosa.

Topics: Adolescent; Adult; Anesthesia, Local; Anesthetics, Local; Cautery; Clinical Trials as Topic; Drug Combinations; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Prilocaine; Warts

Using an percutaneous anesthetic Lidocaine ointment (EMLA cream 5%), we treated patients with mollusca contagiosa, condylomata acuminata, and verrucae plantaris by superficial curettage or electrocaustic surgery. The same presurgical procedure was applied in taking biopsies from the glans penis. The analgesia achieved was complete in all patients with mollusca contagiosa, condylomata acuminata, and penal biopsies. In those with verrucae plantaris, the anesthesia was incomplete but tolerable, also in children. We discuss the pharmacological effects of and further indications for this new percutaneous anesthetic ointment.

Topics: Anesthetics, Local; Biopsy; Condylomata Acuminata; Drug Combinations; Electrocoagulation; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Molluscum Contagiosum; Ointments; Penile Neoplasms; Prilocaine; Skin Diseases; Skin Neoplasms; Warts