Clinical evaluation of neodymium-doped yttrium aluminum garnet laser versus tuberculin purified protein derivative in the treatment of palmoplantar warts

Background Various therapeutic approaches have been used to treat palmoplantar warts with different success rates. Laser therapy eliminates warts through photothermal or photomechanical destruction, offering both safety and high clearance rates. Tuberculin purified protein derivative (PPD) is an immunomodulatory treatment commonly used for cutaneous warts. Objective To evaluate the effects of Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) Laser versus Tuberculin PPD in treatment of palmoplantar warts. Patients and methods In this randomized controlled study, 30 patients with palmoplantar warts were divided into two groups. Group A received Nd: YAG laser treatment every 4 weeks for up to four sessions, while group B received intralesional Tuberculin PPD injections every 2 weeks for up to six sessions. Clinical assessments and photographs were taken before treatment and 6 months after the first session. Results Number of warts were reduced significantly before and after treatment with Nd: YAG laser ( P <0.041) while PPD showed no statistical difference ( P >0.1). Between both groups, number of warts showed significant difference in favor of Nd: YAG ( P <0.002). Comparing both groups at 4 months, Nd: YAG showed a significant difference compared with PPD ( P ≤0.004) and at 6 months ( P ≤0.003) as regards the mean size. Conclusion Long-pulsed Nd: YAG laser (1064 nm) is an effective and well tolerated method in the treatment of warts compared with PPD.