Common warts are caused by the human papillomavirus
(HPV). They affect 2% to 20% of school-aged children.1
This infection can cause physical and emotional distress
in patients.2 There are different available treatments for the common
wart, but in all cases, none of these treatments are individually
effective in eradicating the lesions. Moreover, until now,
there have not been any available specific antiviral therapies for
HPV infection.3 The first line of therapy is salicylic acid resulting
in regression of warts in two thirds of patients.4,5 In addition,
cryotherapy, usually using liquid nitrogen, which freezes tissues
and destroys the warts, is one of the most effective treatments.
Chemical cauterization materials, such as monochloroacetic acid
and trichloroacetic acid (TCA), have also been used as treatment.
6Trichloroacetic acid is a caustic and hemostatic agent. A
saturated solution could be used alone for the treatment of many
benign and dysplastic skin lesions. A solution of TCA with a concentration
of 60% to 90% has been used for genital warts and for vaginal and anal lesions.7,8 Trichloroacetic acid is applied topically
and must be allowed to dry until a white frosting develops, and
its application is accompanied by a burning sensation that lasts
for two to five minutes.9 Studies using TCA 80% on genital warts
have reported clearance rates of 70% to 81% after six applications.
10,11 We hypothesized that applying a lower-concentration
TCA solution could have different improvement results for the
treatment of the common wart. This study was conducted to
evaluate the clinical efficacy of TCA 80% and a lower concentration
of TCA solution (35%) in the treatment of common warts.
To date, this lower-concentration solution has not been used for
treatment of the common wart.
Patients and Study Procedures
This clinical trial study was approved by the Medical Ethics Committee
of Mashhad University of Medical Sciences in Mashhad,
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