Comparison and evaluation of the effectiveness of 90% trichloroacetic acid (TCA), 50% trichloroacetic acid (TCA) and cryotherapy applications for verruka plantaris

Introduction and Purpose: Verrucae are benign tumoral lesions that develop as a result of infection of the skin and mucous membranes with Human papillomaviruses (HPV). Cryotherapy is one of the most common treatment methods practiced by physicians for verruca plantaris. High concentration TCA, which is a different treatment method, is also used. In our study, it was aimed to determine the response to treatment and possible side effects of 90% and 50% TCA (trichloroacetic acid) and cryotherapy in verruca plantaris and to contribute to the literature. Materials and Methods: Sixty patients, aged between 18-65 years, who applied to Gaziantep University Faculty of Medicine, Department of Dermatology and Venereal Diseases between May-December 2021 and had more than three verrucas on the soles of the feet were included in the study. Patients were randomly divided into three groups of 20 each; 90% TCA was applied to the 1st group, 50% TCA to the 2nd group and cryotherapy to the 3rd group. TCA applied groups were treated with 3 sessions with 1 week intervals. TCA was dripped onto a cotton swab in amounts ranging from 0.5 to 1 cc, depending on the structure of the verruca, and the procedure was terminated by contacting this cotton swab on the verruca until the lesion turned white. Photographs of each patient were taken before the procedure and after 3 sessions and placed in their folders. In the cryotherapy group, 3 sessions of application, 2 weeks apart, using liquid nitrogen, 2 cycles of the lesion with the spray method, 2 mm in 15 seconds intervals diameter freezing ring was formed. Photographs of each patient were taken before and after the procedure and placed in their files. Results: The mean age and standard deviation of the participants in the study were 29.24 ± 14.49 in the 1st group, 26.13 ± 6.71 in the 2nd group and 22.72 ± 4.7 in the 3rd group. There was no significant difference between the post-treatment patient scores and research scores in all three groups (p=0.968, p=0.073). There was no significant correlation between age and patient and investigator scores in all three groups. A very strong positive correlation was found between patient scores and investigator scores in the 90% tca group (r=0.813, p=0.001). Conclusion: There was no difference in efficacy between 90% TCA, 50% TCA concentrations and cryotherapy. On the contrary, side effects such as pain and erythema were more common in cryotherapy. Keywords: Trichloracetic acid, Verruca plantaris