tretinoin and Warts

Warts and molluscum contagiosum are common skin diseases in children and are usually self-limiting. The decision of whether to treat children with molluscum or warts should be individualized to the patient and his or her family. Considerations include how symptomatic the lesions are, the extent and duration of disease, the ability of the child and the parents to tolerate and comply with treatment recommendations, and any underlying medical conditions (Table, see page 219). Recurrences of molluscum contagiosum and especially warts are common, and realistic expectations regarding the potential for treatment failure and recurrence should be discussed with the child and his or her family prior to initiating any therapy. As pediatric practitioners, we all remain acutely aware of our patients' physical and psychological development and the potential for any intervention to influence this development. Although various treatment modalities now exist for the treatment of these viral diseases, any intervention should be balanced against these considerations.

Topics: Adhesives; Adjuvants, Immunologic; Administration, Topical; Aminoquinolines; Cantharidin; Child; Cimetidine; Cryotherapy; Curettage; Fluorouracil; Hot Temperature; Humans; Imiquimod; Immunotherapy; Irritants; Keratolytic Agents; Laser Therapy; Molluscum Contagiosum; Occlusive Dressings; Pediatrics; Podophyllin; Salicylic Acid; Tretinoin; Warts

Invasive squamous cell carcinoma (SCC) of the skin is one of the most common cancers in the United States, with no proven means for prevention other than systemic retinoids, which have significant toxicity, and sunscreen. We sought to determine the risk factors for invasive SCC on the face or ears in a high-risk population comprising 1,131 veterans in the Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial. Participants were required to have been diagnosed with at least two keratinocyte carcinomas (KCs) in the 5 years prior to enrollment. The median duration of follow-up was 3.7 years. Twenty-three percent of the participants developed a new invasive SCC, and the cumulative risk of invasive SCC was 30% at 5 years. The following factors independently predicted for new invasive SCCs: number of invasive SCCs and number of in situ SCCs in the 5 years prior to enrollment, actinic keratoses count at enrollment, a history of ever use of topical 5-fluorouracil, and total occupational time spent outdoors. In contrast, the use of angiotensin-convering enzyme inhibitors or angiotensin receptor blockers during the study and a history of warts anywhere on the body were found to protect against new invasive SCCs. These independent predictors remained the same for all SCCs (invasive and in situ combined). The number of basal cell carcinomas in the 5 years prior to enrollment, sunburns, sun sensitivity, and recreational sun exposure were not associated with new SCCs. These findings identify key risk factors for additional SCCs in patients with multiple prior KCs, and suggest that a history of warts may be associated with reduced SCC risk.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Risk Factors; Skin Neoplasms; Sunburn; Sunscreening Agents; Tretinoin; Veterans; Warts

There are multiple treatment modalities for periungual warts (PWs), although most are destructive and painful, limiting their application. Radiotherapy is a non-invasive method suitable for treating PW patients with contraindications to invasive procedures. To investigate the efficacy and safety of topical Tretinoin combined with Superficial X-ray therapy (SXRT) in treating PWs. This study included patients with 65 PWs who underwent treatment and a 3-month follow-up. Twenty four PWs were subjected to SXRT alone (group A). The remaining 41 PWs were subjected to SXRT combined with the application of the Tretinoin cream from the first day (group B). The overall clinical response rate, recurrence rates, cosmetic outcomes, and adverse events were observed during the follow-up period. The complete clearance rate (75% vs. 92.7% in groups A and B, respectively) and healing times (19.9 vs. 16.0 days in groups A and B, respectively) between the two groups were significantly different (p < 0.046 and 0.04), indicating the combination treatment is more effective. Notably, there was no damaging or permanent deformation on the nail, and the other adverse effects were mild and bearable. Topical Tretinoin combined with SXRT therapy is an effective strategy for treating PWs, with minor side effects. It is painless and with excellent cosmetic outcomes.

Topics: Humans; Nail Diseases; Treatment Outcome; Tretinoin; Warts; X-Ray Therapy

Topics: Adult; Antineoplastic Agents; Humans; Interferon alpha-2; Interferon-alpha; Male; Papillomavirus Infections; Recombinant Proteins; Treatment Outcome; Tretinoin; Warts

Nevoid hyperkeratosis of the nipple and areola is a rare dermatosis with unknown etiology, (Perez-Izquierdo JM, Vilata JJ, Sanchez JL, et al. Retinoic acid treatment of nipple hyperkeratosis. Arch Dermatol 1990;126:687-688). Only 40 cases have been reported until 1997 (Alpsoy E, Yilmaz E, Aykol A. Hyperkeratosis of the nipple: report of two cases. J Dermatol 1997;24:43-45). The disease has a benign course and may only be a cosmetic problem. Different modalities have been used in the treatment of NHNA. In our case treatment with topical retinoic acid induced an acceptable response.

Topics: Administration, Cutaneous; Adult; Breast Diseases; Female; Humans; Hyperpigmentation; Keratins; Keratolytic Agents; Keratosis; Nipples; Tretinoin; Warts

Hyperkeratosis of the nipple and areola is a rare condition; its characteristic properties are verrucous thickening and brownish discoloration of the nipples and areola. The nevoid form of the disease is extremely rare, usually seen in women in the second or third decade of life. The nipple is seldom affected alone. We report two cases of the nevoid form of hyperkeratosis of the nipple. In both female patients, lesions developed after puberty and were confined to both nipples alone. One of the patients' lesions became darker and more verrucous during pregnancy, making breast feeding impossible.

Topics: Adolescent; Adult; Breast Diseases; Breast Feeding; Female; Humans; Hyperpigmentation; Keratolytic Agents; Keratosis; Nipples; Pregnancy; Pregnancy Complications; Tretinoin; Warts

Topics: Administration, Cutaneous; Adolescent; Adult; Child; Child, Preschool; Dermatitis, Irritant; Dermatologic Agents; Facial Dermatoses; Female; Humans; Irritants; Ointments; Salicylates; Salicylic Acid; Tretinoin; Warts

Plantar and common warts can be cured with great efficacy by the intralesional injection of bleomycin using the jet injector. Traditional keratolytic treatment and electro-desiccation are also still in use. Condyloma acuminata respond to podophyllin combined with cryotherapy. It is advisable to use the CO2 laser in more extensive infections. Interferon injections also may be helpful in these cases. Plane warts can be treated by tretinoin and 5-fluorouracil. In case of diffuse verruca sensitization with diphenylcyclopropenone can be considered.

Topics: Bleomycin; Condylomata Acuminata; Cryosurgery; Electrosurgery; Fluorouracil; Humans; Keratolytic Agents; Laser Therapy; Podophyllotoxin; Tretinoin; Warts

Topics: Adult; Foot; Foot Dermatoses; Humans; Immunologic Deficiency Syndromes; Isotretinoin; Male; Tretinoin; Warts

A disabling case of keratodermia palmoplantare papuloverrucoides progressiva is described. Less severe cases have been reported in the American literature as keratodermia punctata. The verrucoid lesions of our patient were spontaneously shed during treatment with the aromatic retinoid etretinate, and a daily maintenance dose of 25 mg was necessary to prevent recurrence.

Topics: Adult; Etretinate; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Male; Middle Aged; Tretinoin; Warts

Topics: Adult; Etretinate; Facial Dermatoses; Hand Dermatoses; Humans; Male; Sarcoidosis; Tretinoin; Warts

Persisting human papilloma virus (HPV) 2 induced common warts of a chronic lymphatic leukemia patient were orally treated with aromatic retinoid Ro 10-9359 (Tigason). Clinically, the lesions improved rapidly. Virus-specific cytopathogenic effects (CPE), virus particles and viral DNA were no longer detectable. Therapy was discontinued because of the development of a liposarcoma, which led to a complete relapse of the cutaneous lesions. HPV-2 specific parameters, CPE and viral DNA, were restored. Comparison of the restriction enzyme cleavage patterns revealed that warts before and after therapy contained the same HPV-2 subtype. The implications of the observation on the effect of Tigason on virus-induced papillomas are discussed.

Topics: Administration, Oral; Aged; Etretinate; Hand; Humans; Leukemia, Lymphoid; Male; Skin Diseases; Tretinoin; Warts

Two patients with extensive verrucae plantares have been treated successfully with the retinoic acid derivative Ro 10-9359. Both patients were practically unable to walk due to widespread involvement of the plantae pedium. In a second series of 12 patients with verrucae vulgares this form of therapy produced unsatisfactory results. In 2 further patients with verrucae plantares healing was achieved in one, and also in a patient with verrucae planae. A patient with verrucae periunguales did not react to the treatment. The dosage was gradually increased to above the normal value of 1.0 mg/kg body weight per day, according to individual tolerance. The aim was to reach a dose of over 1.5 mg/kg body weight per day. The side effects were therefore impressive and interruption or termination of therapy was often necessary. However, new side effects have not been observed with this high dosage and this new indication, apart from psoriasiform dermatitis and an intermittent vegetative disturbance, the latter without clear evidence of a causal relation to the Ro 10-9359 medication. Pathological liver values have not been observed. Treatment with retinoid appears to be appropriate in cases with verrucae plantares, especially where conventional methods do not prove satisfactory.

Topics: Adolescent; Adult; Etretinate; Female; Foot Diseases; Humans; Male; Middle Aged; Tretinoin; Warts

Topics: Adult; Drug Eruptions; Female; Humans; Leg Dermatoses; Patch Tests; Tretinoin; Vitamin A; Warts

Topics: Adolescent; Adult; Child; Humans; Middle Aged; Tretinoin; Vitamin A; Warts

Topics: Cryosurgery; Curettage; Dinitrochlorobenzene; Fluorouracil; Humans; Tretinoin; Warts

Up to date, the treatment of palmar/plantar hyperkeratoses presents a therapeutic problem. The known therapeutic procedures result in short-term improvement only, if any at all. In these investigations involving 68 patients suffering from palmar/plantar hyperkeratoses of different etiology, small doses of vitamin A acid locally applied, produced a striking improvement in hypertrophic lichen planus of palms or soles: the regression was complete and in most cases permanent. The skin texture of patients with genetic keratoses and callosities became normal within a few weeks: but this condition remained free of symptoms only as long as vitamin A acid was used as a maintenance dose once or twice weekly. In hyperkeratotic eczema, pityriasis rubra pilaris, and verrucae plantaris vitamin A acid locally applied was found to be unsuitable for treatment. The possible side effects of this treatment are mentioned. Several possibilities regarding the way of action of vitamin A acid are discussed.

Topics: Callosities; Eczema; Humans; Keratoderma, Palmoplantar; Lichen Planus; Long-Term Care; Occlusive Dressings; Ointments; Pityriasis Rubra Pilaris; Tretinoin; Vitamin A; Vitamin A Deficiency; Warts

An ointment with 2% vitamin A acid was applied under occlusion to 50 patients with plantar warts. Only 17 could be considered as cured after 2-10 weeks of treatment.

Topics: Administration, Topical; Foot Diseases; Humans; Tretinoin; Vitamin A; Warts