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Cryosurgical Treatment of Warts: Dimethyl Ether and Propane Versus Liquid Nitrogen -- Case Report and Review of the Literature

October 2011 | Volume 10 | Issue 10 | Original Article | 1174 | Copyright © October 2011


equate for keratinocyte necrosis, melanocytes may be destroyed at -5°C. Consequently, the potential for post-exposure hypopigmentation also exists, especially in dark skinned individuals. But perhaps the greatest morbidity is not the immediate burns or pigmentation changes, but, rather, the delay in proper treatment of a malignant lesion masquerading as a viral wart.
In summary, the above case clearly demonstrates a poor outcome following multiple treatments with an OTC wart-freezing device. But given the lack of prospective data comparing OTC wart-freezing cryotherapy to standard cryotherapy with liquid nitrogen, only tentative conclusions regarding the safety and efficacy of these OTC products should be made.

DISCLOSURES

The authors have no conflict of interest to declare.

REFERENCES

  1. Massing AM, Epstein WL. Natural history of warts: a two-year study. Arch Dermatol. 1963;87:306-310.
  2. Brodell RT, Mostow E. Cost-effectiveness of wart treatment. Br J Dermatol. 2008;158(2):419-420.
  3. Kuflik EG, Gage AA. Cyrosurgical treatment for skin cancer. New York: Igaku-Shoin Medical Publishers.1990.
  4. Dawber R, Cryosurgery: unapproved uses, dosages, or indications. Clin Dermatol. 2002;20(5):563-570.
  5. Caballero MF, Plaza NC, Pérez CC, et al. Cutaneous cryosurgery in family medicine: dimethyl ether-propane spray versus liquid nitrogen. Aten Primaria. 1996;18(5):211-216.
  6. Erkens AM, Kuijpers RJ, Knottnerus JA. An end to office hours for warts? A randomized study of the effectiveness of liquid nitrogen and of the Histofreezer. Ned Tijdschr Geneeskd. 1991;135(5):171-174.
  7. Burkhart CG, Pchalek I, Adler M, Burkhart CN. An in vitro study comparing temperatures of over-the-counter wart preparations with liquid nitrogen. J Am Acad Dermatol. 2007;57:1019-1020.
  8. Ramsey K, Ragan C, Dheansa B. Adverse effects of over the counter cryotherapy. Burns. 2007;33(4):533-534.
  9. Sammut SJC, Brackley PTH, Duncan C, et al. Frostbite following use of a commercially available cryotherapy device for the removal of viral warts. Dermatology Online Journal. 2008;14(6):9.

ADDRESS FOR CORRESPONDENCE

Craig G. Burkhart MD MPH5600 Monroe StreetSuite 106BSylvania, OH 43560Phone: (419) 885-3403Fax: (419) 885-3401cgbakb@aol.com