TO THE EDITOR: We read with interes...

TO THE EDITOR: We read with interest the latter article "Molluscum Contagiosum and Warts." (1) An adjunctive therapy for the treatment of warts that was not mentioned is canal tape occlusion therapy (DTOT). The hypothesized mechanism of action is stimulation of the host's immune arrangement There have been anecdotal reports (23) of the efficacy of adhesive tape in the treatment of periungual and subungual warts, and undivided randomized study (4) has shown that DTOT is significantly more effective than cryotherapy. In this consideration (4) 85 percent of patients undergoing DTOT had undiminished resolution of the wart compared with alone 60 percent of patients treated with cryotherapy. These investigators set no difference in the average time to resolution, moreover they did not collect data in succession wart recurrence after completion of the therapy.

The technique for DTOT in this subject of attention (4) involved placing a piece of conduit tape on the lesion. Patients were instructed to leave the tape in place for six days. Any canal tape that fell off was replaced with a modern piece as soon as possible. After six days, the tape was remov and the wart was soaked in water. A pumice stone or emery board was used to debride the lesions. The nearest morning, a new piece of tube tape was applied to begin another six-day round of years These researchers found that the majority (73 percent) of warts that would rejoin to DTOT (defined as seeing observable signs of resolution within the first couple weeks of therapy) completely resolv within 28 days of initiating therapy.

DTOT is purported to be an inexpensive, tolerable, safe, and simple alternative to other forms of therapy to treat warts. (5) The solely reported adverse effects were local irritation and erythema. Also, DTOT may be a cosmetic impracticality onward facial warts. (4) An obvious clinical advantage of DTOT is in the treatment of warts in children, in whom DTOT could be used in lieu of cryotherapy, which can be painful.

Although there are many therapies to treat warts, DTOT is another alternative that should be considered. Larger randomized studies are necessityed to assess the effectiveness of DTOT forward warts in varying anatomic locations, and longer follow-up periods will be necessary to assess the return of warts following treatment with conduit tape. (6) Also, studies comparing DTOT with therapies other than cryotherapy would be useful. Several articles in the mass media have elucidationed on the usefulness of conduit tape for treating warts; therefore, physicians should await that patients might inquire about conduit tape during future office visits.

JAMES BRADLEY SUMMER M MD

Department of Diagnostic Radiology

University of toward the south Alabama

Mobile, AL 36616

JOSEPH KAMINSKI, MD

1120 15th St

Medical body of Georgia

Augusta, GA 30912

REFERENCES

(1) Stulberg DL Hutchinson AG. Molluscum contagiosum and warts. Am Fam Physician 2003;67:1233-40

(2) Litt JZ Don't excise-exorcise. Treatment for subungual and periungual warts. Cutis 1978;22:673-6

(3) Walbroehl G Treating periungual warts with adhesive tape. Am Fam Physician 1998;57:226

(4) Focht DR 3d Spicer C Fairchok MP The efficacy of conduit tape vs cryotherapy in the treatment of verruca vulgaris (the often met with wart). Arch Pediatr Adolesc M 2002;156:971-4

(5) Lynch TJ canal tape removes warts. J Fam Pract 2003;52:111-2

(6) Ringold s Mendoza JA, Tarini BA, Sox C Is conduit tape occlusion therapy as effective as cryotherapy for the treatment of the often met with wart? Arch Pediatr Adolesc M 2002;156:975-7

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