Cantharidin-podophylotoxin-salicylic acid versus cryotherapy in the treatment of plantar warts: a randomized prospective study

J Eur Acad Dermatol Venereol. 2012 Jul;26(7):889-93. doi: 10.1111/j.1468-3083.2011.04186.x. Epub 2011 Jul 26.

Abstract

Background: Plantar warts are refractory to any form of treatment. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin and 30% salicylic acid (CPS). However, no data exists comparing the efficacy of this formulation with another treatment. Cryotherapy is a method that is also widely used in the treatment of plantar warts. Likewise, there is no evidence that it is more effective than any topical treatment.

Objective: We aim to compare the efficacy of topical CPS and cryotherapy in the treatment of plantar warts.

Methods: Patients with plantar warts were consecutively treated with either cryotherapy or topical CPS. Both treatments were performed every 2 weeks for up to five sessions. In patients without complete clearance, the therapy was switched to the other treatment option.

Results: Twenty-six patients with a total of 134 warts were included. Fourteen patients were completely cleared of their warts with topical CPS, whereas only in five of 12 patients (41.7%) warts were completely cleared with cryotherapy (P=0.001). In seven patients without complete clearance, the therapy was switched to CPS. Four of these patients missed the follow-up. While the two of the remaining three patients were cleared of their warts, one patient's warts still failed to clear.

Conclusion: Topical CPS is more effective than cryotherapy in the treatment of plantar warts.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cantharidin / administration & dosage
  • Cantharidin / therapeutic use*
  • Combined Modality Therapy
  • Cryotherapy*
  • Female
  • Foot*
  • Humans
  • Male
  • Podophyllotoxin / administration & dosage
  • Podophyllotoxin / therapeutic use*
  • Prospective Studies
  • Salicylic Acid / administration & dosage
  • Salicylic Acid / therapeutic use*
  • Warts / drug therapy*
  • Young Adult

Substances

  • Cantharidin
  • Podophyllotoxin
  • Salicylic Acid