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ZENODO
Article . 2025
License: CC BY
Data sources: ZENODO
Diseases & Research
Article . 2025 . Peer-reviewed
Data sources: Crossref
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‘Warts and All’ - Consider Even Definitive Salvage Radiotherapy for Recalcitrant Adult Viral Warts

Authors: Sharma, Varoon; Talwar, Jai; Cheah, Alison L; Chia, Alvin; Fogarty, Gerald B.;

‘Warts and All’ - Consider Even Definitive Salvage Radiotherapy for Recalcitrant Adult Viral Warts

Abstract

Recalcitrant adult viral warts can cause significant functional and cosmetic impacts. A 60-year-old adult male with a five-year history of recurrent, recalcitrant, and progressive warts of both hands had failed prior treatments with laser, cryotherapy, and topical therapies. Salvage radiotherapy (RT) was considered. RT volumes were administered to gross disease only with the margin to field edge dependent on modality. Using superficial radiotherapy (SXRT) with beam quality of half value layer of 1.9 millimeters aluminium equivalent, an area on the dorsum of the non-dominant (left) hand measuring 4 × 3 centimetres (cm) received 19.8 Gray (Gy) to skin surface in 11 daily fractions of 1.8 Gy. When little reaction was noted, the fraction size was increased to 3 Gy, delivering another nine fractions to 27 Gy, giving a total dose of 46.8 Gy. Wart lysis, erythema, and desquamation healed over four weeks, this complete response (CR) continuing at more than two years. We then considered SXRT dose of 50 Gy in 20 fractions over four weeks to be the correct SXRT dose. A further 39 areas were treated with SXRT over a year with continuing CR, continuing for at least a year following the last area treated. A larger area of 11 × 4 cm on the dorsum of his dominant right hand received 60 Gy in 24 fractions using Volumetric Arc Therapy (VMAT) had CR also continuing at two years post treatment. Radiotherapy to a high dose may be considered for salvage of recalcitrant adult viral warts. More research is needed.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green