Local Hyperthermia At 44℃ For Treatment Of Plantar Warts: A Randomized, Singleblind, Controlled Clinical Trial

ObjectivesTo assess the clinical efficacy and pain relief of local hyperthermia(44℃) in the treatment of plantar warts.MethodsA randomized, patient-blinded, placebo-controlled trial was conducted. Sixty outpatients with plantar warts were consecutively enrolled. A computer-generated randomization table was used to serially allocate patients to the treatment or control group. Thirty patients who were allocated into the treatment group received a red spot from the device and heating sensation as well, on the targeted lesion. Thirty patients in the control cohort received a red spot on targeted lesion without heating sensation. For patients with multiple lesions, we choose only a single target lesion, either the one with most prominent load-bearing pain or the one biggest. Patients with load-bearing pain, if any, were asked to rate it using a 0 to 10 ascending visual analog scale. Patients received hyperthermia treatment or sham treatment once a day for 3 consecutive days, with each treatment session lasting 30 mins. Two weeks later, patients received similar treatments for 2 consecutive days. On completion of treatment, patients were followed up at the first, second and third months. Patients were further followed-up by the end of 6 months to document whether there were any further changes or relapse of lesions.ResultsSixty patients with plantar warts were enrolled. In the treatment group, two patients dropped out of or were excluded from the study:1 received a lesional interferon injection after 3 sessions of local hyperthermia, and 1 lost contact immediately after finishing the last treatment session; In the control group, four patients dropped out of or were excluded from the study:2 dropped out after 1 or 2 treatment session,1 received cryo-therapy after 2 months of follow-up visits, and 1 received a lesional interferon injection after 2 treatment sessions.By the end of three months,53.57%(15 out of 28 cases) in the treatment group and 11.54%(3 out of 26 cases) in the control group were evaluated as cured. A statistically significant difference was reached (X-square test,χ2= 10.72, P=.001). 80.00%(12 out of 15 subjects) in the treatment group with initial complaints of load-bearing pain reported decreased sensation of pain; 14.29%(2 of 14 subjects) in the placebo-treated group reported decreased sensation of pain. There was a statistically significant difference in the improvement of load-bearing pain between the two groups (χ2= 9.83, P<.01). By the end of 6 months,1 more patient was cured in each group. No relapse was observed in the treatment group, whereas a relapsing case occurred in the control group. There is only minor heating or burning sensation in the treated patients, no adverse events were observed.ConclusionsLocal hyperthermia at 44℃was effective in the treatment of plantar warts. Local hyperthermia could ameliorate the load-bearing pain in a high proportion of the treated patients.