Modern approaches to nonspecific treatment and prevention of Verruca plantaris palmoplantar warts. A review

In this work, we carry out a review of scientific literature in the fields of medical dermatology and medical microbiology concerning the etiological factors of palmoplantar warts, i.e., human papillomaviruses (HPV) and marsupial fungi of the Trichophyton rubrum species of the Arthrodermataceae family. A content analysis of the socially significant topic of the most common and often recurrent infectious and inflammatory diseases of the foot and palm skin is conducted. The etiological factor is represented by the resident inhabitants of the human skin microbiome with a ubiquitous distribution, the opportunistic fungi Trichophyton rubrum (Castell.), Sabour., 1911, in symbiosis with non-oncogenic types of human papillomaviruses 1, 3, 27, 29, and 57. The review presents a conceptual analysis of the microbiological properties of symbionts, which are clinically significant in medical microbiology, diagnostic methods, and current approaches to treating the disease. The efficacy, advantages, and disadvantages of chemotherapeutic, physical, and surgical methods are discussed. The problems associated with frequent recurrences of warts and the lack of a unified effective treatment approach are described. A method for non-invasive treatment of plantar warts using silver nitrate, which ensures a reduction in the proportion of relapses to 8% over a 3-year observation period, is presented. Signs of the pathomorphological process develop in the epidermis and dermis with the participation of opportunistic fungi and/or HPV viruses against the background of immunodeficiency, such as HIV infection.

1. Briko NI, Lopukhov PD, Kaprin AD, Novikova EG, Trushina OI, Haldin H, Isaeva DR, Skvortsova A.I. HPV-associated lesions in the Russian Federation: Assessment of the problem. Journal of Modern Oncology. 2019;21(1):45–50 (In Russ.)].

2. Vlahovic TC, Khan MT. Th e human papillomavirus and its role in plantar warts: A comprehensive review of diagnosis and management. Clin Podiatr Med Surg. 2016;33(3):337–53. doi:10.1016/j.cpm.2016.02.003

3. Shmelev LV, Orujov AV, Ushakova EV, Fadeeva MV. Treatment of vulgar and plantar warts. Evrazijskoe Nauchnoe Obiedinenie. 2018;123(46):185–9 (In Russ.)].

4. Electronic resource. Access mode: https:// www.ismos.ru/guidelines/doc/virusnye_borodavki.pdf] (In Russ.)].

5. Khlebnikova AN, Selezneva EV, Dorokhina OV. Treatment of vulgar and plantar warts. Vestnik Dermatologii i Venerologii. 2015;91(1):122–8 (In Russ.)].

6. Stranad ko EF. Mechanisms of action of photodynamic therapy. 3rd All-Russian Symposium “Photodynamic Th erapy”. Moscow, 1999: 3–15 (In Russ.)].

7. Kungurov NV, Kuznetsova YuN, Gorbunov AP, Tolstaya AI. Combined method of treatment of palmoplantar warts. Farmakoterapija v Dermatovenerologii. 2011;(2):62–9 (In Russ.)].

8. Wolff K, Johnson RA. Fitzpatrick’s color atlas and synopsis of clinical dermatology. Sixth edition. Medical. 2009:771–6.

9. Witchey DJ, Witchey NB, Roth-Kauff man MM, Kauff man MK. Plantar warts: epidemiology, pathophysiology, and clinical management. National Center for Biotechnology Information, US. National Library of Medicine. 2018;118 (2): 92–105. doi: 10.7556/jaoa.2018.024

10. Foresta C, Noventa M, De Toni L, Gizzo S, Garolla A. HPV-DNA sperm infection and infertility: from a systematic literature review to a possible clinical management proposal. Andrology. 2015;3(2):163–73. doi: 10.1111/andr.284

11. Beliaev BV, Miasnikov LL. Plantar, fl at, vulgar warts: Current approaches to treatment. Russian Journal of Clinical Dermatology and Venereology. 2012;10(6):55–9 (In Russ.)].

12. Ahmad M. Al Aboud; Pramod K. Nigam: Wart (Plantar, Verruca Vulgaris, Verrucae). National center for biotechnology information, U.S. National Library of Medicine. 2019. Bookshelf ID: NBK431047PMID: 28613701.

13. Dardet JP, Blasingame NP, Okpare D, Leffler L, Barbosa P. Plantar Verrucae in human immunodefi ciency virus infection: 25 years of research of a viral coinfection. Clin Podiatr Med Surg. 2020;37(2):317–25. doi: 10.1016/j.cpm.2019.12.010

14. Litvinov MA. Determinant of microscopic soil fungi. Leningrad, Nauka. 1967; 304 (In Russ.)].

15. Vorobyov AA., Bykov AS. Atlas of medical microbiology, virology and immunology. Textbook for medical students. Moscow, Meditsin. Inform. Agenst. 2003:168– 9 (In Russ.)].

16. Strelnikova NV, Panasevich AV, Chirkova MA, Koltsov IP, Koval AN, Cherchenko TI, Netepenko NN, Ustyugova SO. Method non-invasive treatment of palmoplantar warts/bumps. Application 2018105242. 2018.02.12. Patent for invention RF 2689026 23.05. 2019. Bull. 15 (In Russ.)].

17. Hogendoorn GK., Bruggink SC., de Koning MNC, Eekhof JAH, Hermans KE, Rissmann R, Burggraaf J, Wolterbeek R, Quint KD, Kouwenhoven STP, Bouwes Bavinck JN. Morphological characteristics and human papillomavirus genotype predict the treatment response in cutaneous warts. Br J Dermatol. 2018; 78(1):253–60. doi: 10.1111/bjd.15758

18. Walczuk I, Eertmans F, Rossel B, et al. Effi cacy and safety of three cryotherapy devices for wart treatment: a randomized, controlled, investigator-blinded, comparative study. Dermatol Ther (Heidelb). 2018;8(2):203–16. doi: 10.1007/s13555-017-0210-5

19. Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfi eld-Jones SE. British association of dermatologists' guidelines for the management of cutaneous warts. 2014. Th e British Journal of Dermatology. 2014;171(4):696–712.

20. Geinits AV, Tsyganova GI. Laser technologies in medicine: present and future. Materials of the scientifi c and practical conference, December 4–5, 2014 M.: Laser medicine. 2014;18(4):11–2 (In Russ.)].

21. Afsar FS, Erkan CD, Karaca S. Clinical practice trends in cryosurgery: a retrospective study of cutaneous lesions. Postepy Dermatol Alergol. 2015;32(2):88–93. doi: 10.5114/pdia.2015.48048

22. Bruggink SC, Assendelft WJ. Cryotherapy for plantar warts more costly but no more effective than salicylic acid selftreatment. Evid Based Med. 2012;17(5):156–7. doi: 10.1136/ebmed-2011-100481

23. Register of Medicines of Russia® RLS [Electronic resource] – Access mode: https://www.rlsnet.ru/products/rls-spravocnik-lekarstv-21 (In Russ.)].

24. Canti G, De Simone A, Korbelik M. Photodynamic therapy and the immune system in experimental oncology. Photochem Photobiol Sci. 2002;1(1):79–80. doi: 10.1039/b109007k

25. Erdoğan S, Dorittke P, Kardorff B. Pulsed dye laser (FPDL) treatment of a plantar verruca vulgaris and in vivo monitoring of therapy with confocal laser scan microscopy (CLSM). J Dtsch Dermatol Ges.2013;11 (8):760–2. doi: 10.1111/ddg.12110

26. Evans AM. Th e pocket podiatry guide: paediatrics. Churchill livingstone. – 2010; 218–26.

27. Witchey DJ, Witchey NB, Roth-Kauff man MM, Kauff man MK. Plantar warts: epidemiology, pathophysiology, and clinical management. J Am Osteopath Assoc. 2018;118(2):92–105. doi: 10.7556/jaoa.2018.024

28. D’Souza GF, Zins JE. Severe plantar warts in an immunocompromised patient. N Engl J Med. 2017;377(3):267. doi: 10.1056/NEJMicm1616238

29. Giancarlo M, Massimo M. Effi cacy and tolerability of topical green tea extract (Polyphenon E) application in a “therapyresistant” plantar wart. Case Rep Dermatol. 2018;(2):127–32. doi: 10.1159/000489160

30. Gibbs S, Harvey I. Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews. 2006;(3). CD001781. doi: 10.1002/14651858.CD001781.pub2

31. Gollnick SO, Evans SS, Baumann H, et al. Role of cytokines in photodynamic therapy-induced local and systemic infl ammation. Br J Cancer. 2003;88(11):1772–9. doi: 10.1038/sj.bjc.6600864

32. Mashkovsky MD. “Lekarstvennye Sredstva: in 2 volumes,” 10th ed., 1984; 2:400–5 (In Russ.)].

33. Шишкина О.Е., Бутакова Л.Ю., Иванченко Ю.О., Антонов С.С. Микробиологическое обоснование эффективности фотосенсибилизаторов при фотодинамической терапии. Лазерная медицина. 2013;17(1):35–7. [Shishkina OE, Butakova LYu, Ivanchenko YuO, Antonov SS. Microbiological substantiation of the eff ectiveness of photosensitizers in photodynamic therapy. Laser Medicine. 2013;17(1): 35–7 (In Russ.)].

34. Liu J, Li H, Yang F, Ren Y, Xia T, Zhao Z, Cao X, Wang Z, Yin M, Lu S. Epidemiology and clinical profi le of cutaneous warts in chinese college students: A cross-sectional and follow-up study. Sci Rep. 2018;18;8(1):15450. doi: 10.1038/s41598-018-33511-x.

35. Le Cleach L, Trinquart L, Penso-Assathiany D, Chosidow O. Comparative eff ectiveness of cryotherapy and salicylic acid for plantar warts. Arch Dermatol. 2012;148(11):1311–3. doi: 10.1001/archdermatol.2012.2739

36. Boroujeni NH, Handjani F. Cryotherapy versus CO2 laser in the treatment of plantar warts: a randomized controlled trial. Dermatol Pract Concept. 2018;8(3):168–73. doi: 10.5826/dpc.0803a03

37. García-Oreja S, Álvaro-Afonso FJ, García-Madrid M, LópezMoral M, García-Álvarez Y, Lázaro-Martínez JL. Cryotherapy versus topical nitric-zinc complex solution for the treatment of plantar warts: A randomized controlled trial. J Med Virol. 2023;95(11):e29212. doi:10.1002/jmv.29212

38. Wang J, Shen N, Shen H. Successful treatment of multiple plantar and periungual warts by local hyperthermia treatment: A Case Report. Clin Cosmet Investig Dermatol. 2023;16:981–5. doi:10.2147/CCID.S408406

39. Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfi eld-Jones SE. British association of Dermatologists’ guidelines for the management of cutaneous warts 2014. Br J Dermatol. 2014;171(4):696–712. doi:10.1111/bjd.13310

40. Almazan TH, Zain J, Jung JY. Lesion on the Plantar Foot. Shingles. JAMA Oncol. 2015;1(6):833–4. doi: 10.1001/jamaoncol.2015.2107

41. Tracey C. Vlahovic: Th e human papillomavirus and its role in plantar warts. A comprehensive review of diagnosis and management. Clin Podiatr Med. Surg. 2016;33(3): 337–53. doi: 10.1016/j.cpm.2016.02.003