Nd:YAG laser hyperthermia in the treatment of recalcitrant verrucae vulgares (Regensburg's technique)

Abstract

Heat therapy of cutaneous diseases has been used for decades. During the last years several kinds of energy sources, including electromagnetic energy from radiofrequency, microwaves and sonic energy from ultrasound, have been used to produce local hyperthermia. The general principle of this treatment is based on the fact that disease tissue which is being treated is more sensitive to the effects of elevated temperature than normal tissue and thus less able to recover after heat exposure. We report the case of a 54-year-old female patient with recalcitrant verrucae vulgares on the little finger of her right hand and on her left sole, who was treated with Nd:YAG laser hyperthermia. Laser energy was applied twice with an interval of 6 weeks. Laser output power was 10 W, spot size 8 mm and irradiation time up to 20 s. By this technique it was possible to receive a surface temperature of about 40°C for 30 s. After hyperthermia no skin changes like whitish discoloration, blistering or crusting were observed. After the patient had completed the second course a total remission took place. No recurrence was seen in a follow-up period of 3 months. This method could be used in the treatment of recalcitrant warts on the fingers and hands, periungual and other parts of the body including plantar surfaces.