Risk factors for recurrence after successful treatment of warts: the role of smoking habits.

Abstract

BACKGROUND:

Several therapies have been proposed for cutaneous warts without results concerning factors affecting recurrences.

OBJECTIVE:

To determine the importance of individual characteristics and different therapy modalities in the occurrence of relapses.

METHODS:

Observational prospective cohort study including 199 patients affected by multiple plantar warts treated as follows: 49 with keratolytics, 50 with CO2 laser, 50 with pulsed dye laser (PDL) and 50 with cryotherapy. Personal data were evaluated through a questionnaire, and treatment information was collected. A Cox regression analysis was performed to identify independent factors for relapse occurrence.

RESULTS:

Of patients, 57.8% showed a persistent clearance of warts after treatment with a higher recurrence-free interval when treated with PDL. Accordingly, the risk of recurrence was increased with CO2 laser [hazard ratio (HR) 2.92, 95% confidence interval (CI) 1.49-5.74] and keratolytic treatment (HR 3.23, 95% CI 1.60-6.54), as compared to PDL. Furthermore, the multivariate analysis highlighted a higher risk of recurrence in patients between 26 and 35 years (HR 1.88, 95% CI 1.03-3.45), older than 35 (HR 2.23, 95% CI 1.23-4.07) and smokers (HR 4.90, 95% CI 3.09-7.78).

CONCLUSIONS:

Pulsed dye laser is characterized by the lowest rate of recurrence. Furthermore, our study highlights that the risk of warts relapse is 5-fold higher in smokers compared to non-smokers, revealing the importance of the effects of smoking on inflammation and immune response.

• Authors: P L Bencini, S Guida, S Cazzaniga, G Pellacani, M G Galimberti, M Bencini, L Naldi
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 31 Issue 4 Pg. 712-716 (Apr 2017) ISSN: 1468-3083 [Electronic] England
• PMID: 27987326 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2016 European Academy of Dermatology and Venereology.

Chemical References

• Keratolytic Agents

Topics

• Adolescent
• Adult
• Age Factors
• Cryotherapy
• Disease-Free Survival
• Female
• Humans
• Keratolytic Agents (therapeutic use)
• Lasers, Dye (therapeutic use)
• Lasers, Gas (therapeutic use)
• Male
• Middle Aged
• Prospective Studies
• Recurrence
• Risk Factors
• Smoking (adverse effects)
• Warts (therapy)
• Young Adult