Management
There is no single therapy is one hundred percent effective, and various kinds of therapy should be combined. Research on the effectiveness of therapy should take into account the possibility of spontaneous regression. Any decision taken therapy which must be made case by case basis based on the physician experience, patient selection, and implementation of evidence-based medicine. Immunocompromised patients may experience with verruca incomplete cleaning and verruca become resistant to therapy. Verruca left without treatment is a valid management option if the patient is acceptable, but plantar verruca cause pain and verruca the invisible hand and less influence on school activities or led to difficulties at work. Verruca in adults with a long duration of infection and in immunosuppressed patients have little chance to heal spontaneously and more difficult to be treated.
Verruca with different types and different locations require different therapies. Verruca on the face should not be treated with ointment verruca severe irritation because of the risk. Verruca Plana with Koebner phenomena with any destructive techniques can aggravate the disease. Most verruca can be treated by general practitioners and even by the nursing staff.
The main goal is verruca management:
(1) to eliminate verruca without recurrence
(2) without cicatrix's
(3) create a long-term immunity.
General principles of management verruca must see things as follows:
1. not all be eliminated verruca
2. indication to be removed are: pain, interfere with the activity, cosmetic factors, and the risk of malignancy
3. there is no treatment success rate is very high (about 60-70% net in three months)
4. immune response is an important factor in the net verruca. Immunocompromised individuals may not show the net verruca
5. the highest level of cleanliness for the management of a variety usually the younger people who have a short duration of infection.
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