Background

Observational studies have shown promising therapeutic effects of long-pulsed neodymium-doped yttrium-aluminum-garnet (LP-Nd:YAG) laser on warts.

Objective

To evaluate whether LP-Nd:YAG laser was superior to cryotherapy for cutaneous warts.

Methods

In this study, 150 adult patients with warts were randomized equally to receive laser or cryotherapy every 3 to 4 weeks, for a maximum of 4 sessions. The primary outcomes were the cure rates at 16 weeks and 6 months; secondary outcomes included time to clearance of warts and treatment-related adverse effects.

Results

There was no difference in the cure rate for laser versus cryotherapy at 16 weeks (54.1% vs 46.7%, respectively) and 6 months (59.5% vs 57.3%, respectively). However, time to clearance of warts, up to 16 weeks and 6 months, tended to be shorter for laser versus cryotherapy (P = .04 and .08, respectively). Post hoc analyses showed a significantly higher cure rate for laser versus cryotherapy in 3 subgroups of human papillomavirus 2/27/57–induced recalcitrant warts but not in their counterpart subgroups. Laser had more mild adverse effects.

Limitations

Single center.

Conclusions

The overall therapeutic effects of LP-Nd:YAG laser were similar to cryotherapy, but laser may be more effective to relatively recalcitrant warts and may be associated with shorter time to clearance of warts.

中文翻译：

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长脉冲掺钕钇铝石榴石激光与冷冻疗法治疗皮肤疣的比较：一项随机对照试验

背景

观察性研究表明，长脉冲掺钕钇铝石榴石 (LP-Nd:YAG) 激光对疣具有良好的治疗效果。

客观的

评估 LP-Nd:YAG 激光治疗皮肤疣是否优于冷冻疗法。

方法

在这项研究中，150 名成年疣患者被平均随机分配，每 3 至 4 周接受一次激光或冷冻疗法，最多 4 次。主要结果是 16 周和 6 个月时的治愈率；次要结果包括清除疣的时间和治疗相关的不良反应。

结果

激光疗法与冷冻疗法在 16 周（分别为 54.1% 和 46.7%）和 6 个月（分别为 59.5% 和 57.3%）时的治愈率没有差异。然而，疣清除时间长达 16 周和 6 个月，激光疗法比冷冻疗法更短（分别为P  = .04 和 .08）。事后分析显示，在人乳头瘤病毒 2/27/57 诱发的顽固性疣的 3 个亚组中，激光疗法的治愈率明显高于冷冻疗法，但在其对应亚组中则不然。激光有更轻微的副作用。

限制

单中心。

结论

LP-Nd:YAG 激光的总体治疗效果与冷冻疗法相似，但激光对相对顽固的疣可能更有效，并且可能与更短的疣清除时间有关。