Journal of the American Academy of Dermatology ( IF 12.8 ) Pub Date : 2020-10-05 , DOI: 10.1016/j.jaad.2020.09.085 Jian-Jun Liu 1 , Hong-Tian Li 2 , Ying-Yun Ren 3 , Fan Yang 4 , Zhi-Hao Cheng 2 , Tian-Bao Xia 1 , Jun-Lian Liu 1 , Xiao-Jia Cao 1 , Shi-Chao Lu 1
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:
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。