Affiliation:
1. Department of Dermatology Xiangya Hospital, Central South University Changsha China
2. Hunan Engineering Research Center of Skin Health and Disease Xiangya Hospital, Central South University Changsha China
3. Hunan Key Laboratory of Skin Cancer and Psoriasis Xiangya Hospital, Central South University Changsha China
4. National Clinical Research Center of Geriatric Disorders Xiangya Hospital, Central South University Changsha China
5. Xiangya School of Medicine Central South University Changsha China
6. Mobile Health Ministry of Education—China Mobile Joint Laboratory, Xiangya Hospital Central South University Changsha China
Abstract
AbstractBackgroundPlantar warts are common infectious cutaneous growths causing severe physiological and psychological discomforts in patients and heaving global financial burdens. However, paucity of clear‐cut guidelines for plantar warts, selecting appropriate treatments for plantar warts remains challenging. The objective of the study is to evaluate the efficacy and safety of common treatments for plantar warts.MethodsPubMed, EMbase, and The Cochrane Library were searched from inception to March 1, 2023 for randomized controlled trials (RCTs) of plantar warts. The primary outcome (complete response) and secondary outcome (recurrence and pain) were extracted and combined using Bayesian network meta‐analysis (NMA) with random‐effect and fixed‐effect models.ResultsTotally, 33 RCTs were included in the systematic review and quantitative NMA. In NMA of complete response, topical application of 1% cantharidin, 20% podophylotoxin, 30% salicylic acid (CPS), microneedles plus bleomycin (MNB), and intralesional bleomycin injection (INB) were the only three treatments significantly superior to no treatment (NT) and CPS was of the highest possibility to be the top‐ranked treatment (SUCRA = 0.9363). However, traditional warts treatments, salicylic acid (SA) and cryotherapy were not superior to NT.ConclusionsThe NMA has produced evidence for using CPS, MNB, and INB, which are all topical antimitotic treatments, to improve the management of plantar warts. The classic treatment modalities for plantar warts, including SA and cryotherapy, may play a less important role in the clinical practice of plantar warts.