Teledermatology Practical for Cutaneous Wart Treatment

wart on hand, skin problem
In-person clinical and dermoscopic evaluation combined with teledermatology follow-up for cutaneous wart management is investigated.

Home treatment of cutaneous warts with the cryogenic pen is safe and effectivewhen combined with face-to-face and teledermatology consultations, according to findings from a study published in Dermatologic Therapy.

The hybrid exploratory trial included adult patients with single or multiple untreated cutaneous warts on the trunk or extremities from a dermatology clinic in Italy during the COVID-19 pandemic from August to November 2021.

Single cutaneous warts were selected during clinical and dermoscopic evaluation in the patients’ first face-to-face visit. The participants were then instructed to treat the lesions with a prescription-free cryogenic pen with nitrous oxide. The treatment included 1 application (maximum of 3) to be repeated after 2 weeks.

The patients were also asked to submit a clinical photo of the treated lesion at weekly intervals. A final face-to-face evaluation was used to verify the response to home treatment.

A total of 12 patients (mean age, 35 years; range, 18-58 years; 7 men) were included and collectively had 20 cutaneous warts  that ranged in size from 2 to 6 mm.

After treatment, a complete clinical and dermoscopic resolution occurred in 80% of lesions after an average of 1.2 applications per lesion (range, 1-2). A partial response with a decrease in cutaneous wart size occurred in 2 cases, and 2 patients with 1 treated lesion each were lost to follow-up. All patients reported a blister formation that led to a crust in an average of 14.5 days (range, 9-18) after wart freezing.

As adverse events, all patients reported superficial pain during the sessions and blistering and burning sensation for a few days after the treatment. Residual erythema occurred in 12 lesions, and transitory postinflammatory hypopigmentation occurred in 6 lesions. All participants reported that the device was easy to use and were satisfied with the treatment schedule.

“The combination of face-to-face consultations for initial and final visits and teledermatology during the treatment phase could represent a model for other dermatologic conditions as well (eg, acne, rosacea, psoriasis, atopic eczema etc),” stated the researchers.


Micali G, Dall’Oglio F, Verzì AE, Platania H, Lacarrubba F. Home treatment of single cutaneous warts combining face-to-face and teledermatology consultation: a new perspective. Dermatol Ther. Published online April 20, 2022. doi:10.1111/dth.15528