Treatment of Recalcitrant Warts With Occlusive Warming Patches

October 2014 | Volume 13 | Issue 10 | Original Article | 1194 | Copyright © October 2014


Georgia Schuller-Levis MD,a William Levis MD,b and Israel Dvoretzkyc

aLaboratory of Cellular Immunology, Department of Developmental Neurobiology, New York State
Institute for Basic Research in Developmental Disabilities, Staten Island, NY
bNYU Langone Medical Center, New York, NY
cYale University, New Haven, CT

Heat shock protein 70 will be produced from these thermochemical patches and has been shown to induce an autophagic pathway that leads to cross-presentation and activation of MHC class I cytotoxic CD-8 killer cells.8 Future controlled trials are indicated and should investigate the role of the immune system including measuring neutralizing antibodies and MHC class I restricted CD-8 T cell killers. Recent evidence has shown that HPV- laden dendritic cells migrate to the T cell-dependent areas of regional nodes following local heat on the skin.1 Mechanisms of action by heat may include direct killing of the HPV virion with additional immunologic mechanisms that would include dendritic cell antigen presentation of HPV immunogens like E7 to the T cell receptor in the regional node.9,10

CONCLUSION

In three patients, we used a thermochemical pad to raise the local temperature for treatment of recalcitrant warts. The warts cleared in all three patients beginning at 4-5 weeks of daily application for at least 2 hours. The warts completely cleared by the completion of this study. A larger study is underway that is expanding on these pilot data.

DISCLOSURES

The authors have no conflicts of interest to disclose.

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AUTHOR CORRESPONDENCE