Verrucacid, solution for external use, 2 g, 1 pc.
Pharmaceutical action.
It has a cauterizing effect and coagulates proteins.
Indications.
Warts (common, filiform, plantar), papillomas, genital warts of the skin, dry calluses, keratomas.
Contraindications.
Pigmented nevi; arrangement of elements on the red border of the lips and mucous membranes; treatment of skin surface area more than 20 cm2; children's age up to 7 years.
With caution:
pregnancy, lactation period, childhood.
Dosage regimen.
Externally,
using a special applicator or a small thin wooden stick, avoiding contact of the drug with adjacent healthy areas of skin and mucous membranes. Small papillomas (up to 2 mm) - once. Larger papillomas and small warts (2–3 mm) are smeared 3–4 times, taking a break to allow the applied liquid to dry. Before removing warts with a dense keratinized surface on the hands, plantar warts, keratitis, dry calluses, it is necessary to remove horny layers from their surface: apply a keratolytic ointment (including salicylic acid ointment 10% or others) under an occlusive dressing for several hours ( possible sealing with adhesive tape). After which the bandage or adhesive plaster is removed, the skin is steamed in hot water with the addition of sodium bicarbonate and soap for 10–15 minutes and the horny layers are removed (cut off with nail scissors or tongs). The drug is applied to dried skin several times a day, taking 3-4 minute breaks to allow the drug to dry. Warts on the hands and soles are treated 7–10 times with an interval of 3–4 minutes. Keratomas and dry calluses - 3-4 times with an interval of 3-4 minutes. Genital warts: apply to each element separately 1-2 times with an interval of 3-4 minutes. If necessary, re-treatment is carried out 6–8 days after the crusts are rejected. 4–5 procedures are allowed.
Side effects.
Swelling and hyperemia of the eyelid when using the drug in the eye area. Burn (in case of contact with healthy skin).
Interaction.
The components of the drug easily dissolve in the ointment base, and therefore, applying ointments to the area treated with the drug is not recommended.
Special instructions.
It is not recommended to remove genital warts yourself. Their treatment should be carried out on an outpatient basis, in a treatment room by a dermatovenerologist or urologist. During pregnancy and lactation, the use of the drug is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus or child. During lactation, it is not recommended to remove formations localized on the mammary glands and hands. Do not allow the drug to come into contact with mucous membranes (especially the eyes). In case of contact, immediately rinse eyes with plenty of water and consult an ophthalmologist. It is unacceptable to bandage the areas treated with the drug, seal them with a plaster, lubricate them with ointments and remove crusts; Do not reapply the drug before the dates indicated above. Clothing made from synthetic fabrics should not touch the treated area of skin. It is not recommended to apply the drug to formations located in folds (inguinal, anal area, interdigital spaces, etc.) and places with profuse sweating in order to avoid burns to healthy skin of the contacting surface or as a result of the drug spreading over wet skin. The treated area of skin should be allowed to air dry; It is not recommended to lubricate with ointments or wash with water on the first day after treatment. If the drug accidentally comes into contact with healthy skin, it is necessary to immediately, carefully, without rubbing, remove it from the surface of the skin, and then treat the skin area with ethanol (10–40%) or ethanol-containing liquids (lotion, cologne) and rinse thoroughly with warm water and soap. If a burn occurs, it is recommended to use anti-burn and wound-healing drugs. When used correctly, the drug does not leave scars. Particular caution is required when treating children.
Experience of using Vartox cream paste in monotherapy of viral warts
Iskra A.S., Iskra E.L. Medical, St. Petersburg, Russia Family Medicine Center named after I.P. Pavlova, St. Petersburg, Russia
Data are provided on the clinical types of warts associated with various types of human papillomavirus. The methods used to treat warts are analyzed: destructive, external therapy, combined. We present our own experience in the treatment of viral warts with a modern drug for external therapy, which is Vartox cream paste, Russia. The 40% urea (urea) included in the Vartox cream paste has a powerful keratolytic effect - it softens the surface of the wart for the penetration of the additional antiviral component of the 0.1% glycyrrhizic acid paste. Glycyrrhizic acid 0.1% has an antiviral effect, including against human papillomaviruses. By interacting with the virus, glycyrrhizic acid destroys the development phases of the virus and has an immunostimulating effect. The effectiveness of treatment of viral warts was 76% (38 out of 50 patients). Clinical cure was observed in both primary and recurrent nature of the process. The treatment was characterized by the absence of side effects and complications, low trauma, good tolerance, complete tissue restoration without cosmetic defects.
Key words: viral warts, Vartox cream paste, external therapy for the treatment of warts.
The human papillomavirus is ubiquitous. It causes a whole range of benign lesions of the skin and mucous membranes and plays an important role in the pathogenesis of malignant neoplasms. Asymptomatic carriage of the virus also occurs. More than 190 types of human papillomavirus have been described, which are classified into high and low oncogenic risk groups according to their potential to induce cancer. Among the skin diseases caused by the human papillomavirus, three are particularly common. These are simple warts, plantar warts and flat warts. Simple ones account for about 60–70% of all warts and affect almost 20% of children. Plantar warts account for about 20–30%; they are common in teenagers. Flat warts occur in people of any age, accounting for less than 5%. Some types of human papillomavirus selectively infect the epidermis. Among the skin diseases caused by the human papillomavirus, the most common are warts. The disease is a localized benign hyperplasia of the epidermis and manifests itself as papules or plaques [6–8].
Etiology . The human papillomavirus belongs to the Papovaviridae family; it is a DNA-containing virus that multiplies in the nuclei of the epithelium, which leads to the development of infectious acanthosis [8].
Infection . Occurs by contact (when skin comes into contact with affected skin); penetration of infection is facilitated by minor injuries that disrupt the integrity of the stratum corneum of the epidermis. Infection is possible through simple contact in areas of skin trauma, in the gym, or in the swimming pool.
Risk factors . Immunodeficiency, such as HIV infection and immunosuppressive therapy. Risk group: children, elderly people, pregnancy, complicated medical history. Without treatment, warts last for years.
Complaints . The main complaint is a cosmetic defect. Plantar warts cause pain, especially when walking. Minor injuries may cause bleeding.
Simple warts (common types of viruses 3 and 10). Synonyms: verruca vulgaris, common wart, common wart. Elements of the rash. Dense papules with a diameter of 1–10 mm (occasionally even larger); the surface is covered with cracks, horny layers, and vegetations. When localized on the fingers and palms, the skin pattern becomes distorted and disappears. Restoration of fingerprints is a sign of recovery. The color does not differ from the surrounding skin. Dermatoscopy reveals black-brown dots, which are thrombosed dark vessels (capillaries). This is a pathognomonic sign of warts. The shape is round, polycyclic. Arrangement: single element or multiple isolated elements arranged randomly. Near the removed wart, new ones may appear, located in a circle. Localization. Favorite localization is easily injured areas, that is, hands, fingers. Plantar warts (HPV types 1, 2, 4). Synonyms: verruca plantaris, horny wart. Elements of the rash. First, a small shiny papule with clear boundaries, then a keratinizing plaque with a rough, uneven surface. Against its background, small black-brown dots are visible - thrombosed capillaries. The skin pattern is distorted, its restoration is a sign of recovery. Plantar warts heal without scarring. On the contrary, after cryodestruction and electrocoagulation, scars often remain for life. The color does not differ from the surrounding skin. To identify the characteristic black-brown dots, you need to remove the horny masses from the surface with a scalpel. Palpation. Warts located in areas of pressure are painful. Location: small elements merge to form a “mosaic” wart. “Kissing” warts are found on the touching surfaces of the fingers. Localization. Soles: in the projection of the heads of the metatarsal bones, heels, toe pads, and other supporting areas of the foot. Usually a single formation, but 2 or more warts occur. Flat warts. Synonyms: verruca plana, juvenile wart. Elements of the rash. Flat, clearly demarcated papules with a smooth surface, 1–6 mm in diameter. They rise above the surface of the skin by 1–2 mm. The color is light brown, pink or normal skin color. Shape: round, oval, polygonal. In place of scratching - linear. Location: always multiple isolated elements arranged in a cluster. In places of injury, a linear arrangement is possible.
Localization. Favorite localization is the face, especially the chin; dorsum of hands; shins [1–6].
Course and prognosis.
In patients with good immunity, viral warts may resolve on their own without the use of additional medications. In case of immunodeficiency, treatment is necessary, and many methods are often ineffective [2, 3].
Today, there are many topical preparations for removing warts. Drug treatment: cauterizing chemicals, coagulating, local keratolytics, antiviral and immune external agents. In this article we will consider one of the options for drug treatment using the example of Vartox cream paste. External therapy with Vartox cream paste according to the scheme 1 time per day on the area of the formation under a cotton swab and a patch, daily until the formation is completely resolved. Cryodestruction. Carry out when drug treatment is ineffective. Use a stick with a cotton swab or cryodestructor “Frost” for 15–30 s. Liquid nitrogen is applied to the area of formation, covering up to 1–2 mm of healthy tissue. Cryodestruction is repeated several times at intervals of 2–4 weeks. until complete recovery. Several procedures are possible. Freezing destroys only the affected tissue. A significant disadvantage of the method is pain. It can be combined with external therapy before and after the procedure, including the use of Vartox cream paste. Electrocoagulation. More effective than cryodestruction, but more often accompanied by scarring. Before removing flat warts, the skin is lubricated with lidocaine cream; if warts are localized on the palms and soles, local anesthesia is needed. Laser therapy. Used when other methods are ineffective. A carbon dioxide laser or picosecond laser is used. Surgical treatment if the above methods are ineffective. Rationale for the feasibility of using Vartox cream paste: this drug contains urea at a concentration of 40%; urea, or carbamide, acts on the wart so that it gradually becomes soft and can be easily removed with a pumice stone or a scraper. Composition of the cream paste: in addition to 40% urea, or carbamide, Vartox cream paste also contains glycyrrhizic acid in a concentration of 0.1%. Urea allows you to speed up the process of softening a benign formation on the sole and prevents possible complications after its removal. Glycyrrhizic acid has an antiviral effect. Information about the mechanism of action of Vartox cream paste.
The topical preparation Vartox cream paste very effectively fights warts on the soles and palms.
How to use Vartox:
1. The cream paste is applied in a thick layer to the affected area of the foot or palm (hand).
2. Secure with cotton wool and adhesive tape.
3. Removed after a day, the softened wart is removed with pumice.
4. The area is washed with water without using soap.
5. The procedure can be repeated several times until clinical symptoms disappear.
Indications for use. Cream paste is actively used to treat warts of various origins.
Main indications for use of Vartox cream paste: ƒ
- benign formations (viral warts); ƒ
- calluses; ƒ
— preparation for cryodestruction or laser procedures; ƒ
- removal of keratinized skin after removing a wart in another way.
This all relates to the main indications, but, as mentioned above, the drug is used to remove other forms of formations on the skin. For example, warts on the hands may also be an indication for their removal with a urea-based cream paste. But before use, it is necessary to conduct an allergy test. To do this, apply a small amount of cream paste to the skin of the wrist and wait about 15 minutes. If no pathological changes have occurred, there is no itching, there are no rashes, you can safely use Vartox to remove benign growths on the hands. Vartox can be used in the presence of single or multiple plantar warts. In this case, it is necessary to follow a certain order of treatment if there are several formations on the sole at the same time.
Contraindications for use. Among the absolute contraindications for using Vartox cream paste are: ƒ
- malignant or unspecified formations on the skin; ƒ
— the presence of allergic reactions to individual components of the paste; ƒ
— traumatization of a wart, an open wound; ƒ
- trophic ulcers, bedsores.
Relative contraindications: ƒ
- sensitive skin; ƒ
— itching, redness after applying the cream paste; ƒ
- varicose veins on the legs.
Side effects: not pronounced, some of them occur in people with sensitive skin.
These include: ƒ
- itching, severe peeling of the skin around the site of application of the drug; ƒ
- redness, swelling, burning; ƒ
- slight pain during the process of resorption of the wart.
These side effects are not dangerous to health, but rather are a common consequence of using cream paste to remove any formations. If such reactions do not go away within a few hours, you should consult a dermatologist.
Description of diagnostic methods: ƒ
— clinical examination by a dermatologist; ƒ
— dermatoscopy; ƒ
- additional examination methods - general blood test;
— infectious group: antibodies to HIV-1 and 2 and HIV-1 and 2 antigen, syphilis RPR, Anti-HCV, HBsAg;
— quantitative determination of HPV DNA of 15 types.
On the basis of the Medical and Family Medicine Center named after. I.P. Pavlov we observed 50 patients with plantar and palmar warts. All patients completed an anonymous survey. Of these, 20 patients had photographs of formations before and after treatment. All patients were asked to use only external therapy (monotherapy) in the form of Vartox cream paste for 2 weeks to 3 months, depending on the clinical picture and degree of damage, number and size of formations. 60% used external therapy for up to 1 month (in 20% of patients the treatment was 2 weeks, in 40% - 1 month), the remaining 40% used the drug for up to 3 months - of which: 10% - 6 weeks, 10% - 8 weeks, 12% – 10 weeks, 8% – 12 weeks. The study included both men and women aged 18 to 50 years with lesions of the palms and soles. We set ourselves the following tasks: 1. Adhere to monotherapy with Vartox cream paste. 2. Treatment of patients for no more than 3 months, but not less than 2 weeks. 3. Patients had to be examined at least twice and at least once after the entire course of treatment. 4. The study recruited patients of different ages and genders. 5. Patients underwent photographic recording before, during and after treatment with Vartox and a questionnaire. 6. The drug was used only on the skin of the palms and soles. As an indicator of the treatment outcome, we used the dynamics of pain syndrome, subjective sensations, visual (cosmetic) and palpation data of local manifestations of the disease throughout the entire period of use of Vartox cream-paste monotherapy. The intensity of subjective symptoms (burning sensation, pain) was assessed on the following scale: significant severity of symptoms – 6 points; average severity – 3 points; mild severity – 1 point, absence of symptoms – 0. The final assessment of all subjective symptoms was made using a composite index, which is the sum of the scores of all symptoms divided by the number of patients. The summary index was calculated at the 1st and 2nd visits. Clinical tolerability was assessed by patients in questionnaires as good, moderate and poor. No special statistical analysis methods were used. The initial total index of all patients was 142 points. After the 1st visit, the index decreased by 2 times and was 71 points, on the 2nd visit – 30 points. All patients assessed well the tolerability of the drug during the questionnaire. „
1. Vartox cream-paste is a safe remedy for the treatment of various types of warts. During our research, not a single side effect was noted on the skin or other organs and systems. The effectiveness was high and amounted to 76% (38 patients out of 50). In 12 patients (24%), no positive effect of treatment was observed, and hardware methods for removing formations were recommended.
2. The drug is effective when used in monotherapy for the treatment of plantar and palmar warts.
3. The components of this product are well tolerated by patients.
4. The drug can be used daily and for a long time until clinical symptoms resolve under the supervision of a dermatologist, as well as in combination with other methods of destruction or in preparation for them. 5. The drug is not a replacement for laser treatment or cryodestruction, but is an alternative drug treatment or an addition to hardware methods. 6. We recommend the drug as a conservative treatment in dermatological practice for the treatment of warts.
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