الفهرس Only 14 pages are availabe for public view
 |  | from | 166 |  |  |
| | | from | 166 | | |
Abstract
Warts are tumors or growths caused by infection by Human Papilloma virus (HPV). More than 100 HPV subtypes are known. They are common presenting disease in children and adolescents which spread by direct contact or autoinoculation. Warts are classified clinically by location into cutanous and mucosal lesions, there are various types of viral warts including common warts, plantar warts, plane or flat warts, filiform warts, periungual warts, epidermodysplasia verruciformis (EV), oral warts and genital warts.
The treatment of warts poses a therapeutic challenge for physicians. No single therapy had been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches include chemotherapy by (salicylic acid, TCA, formaldehyde, glutaraldehyde, formic acid, cantharidin, 5 fluorouracil, bleomycin, podophyllin, podophyllotoxin, silver nitrates and retinoids), cryotherapy mostly by liquid nitrogen, electrosurgery (curettage and cautary), laser therapy by (CO2 laser, Er: YAG laser, and Nd: YAG laser) and photodynamic therapy.
All these previous destructive modalities are variably effective, frequently painful and usually cause scarring. More over these modalities require individual treatment of each wart and do not prevent recurrence.
There are new trends towards the use of immunotherapy in treatment of warts, as the immune system seems to play an important role in the control of warts infection. Although the exact mechanisms are unclear but most evidences suggest that cell mediated rather than humoral immunity plays an important role in control of HPV infection as the incidence of warts increases in subjects with cell mediated immune defects e.g. (HIV infection patients, malignant diseases. etc…) Various methods have been used to stimulate the immunological response as oral levamisole, cimetidine, zinc sulfate, cidofovir, intralesional interferons, topical DNCB, DPCP, SADBE, imiquimod, intralesional immunotherapy with mumps, candida and trichophyton antigens, intradermal BCG vaccine, and intralesional Mw vaccine.