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Review: common topical applications containing salicylic acid or lactic acid improve clinical cure in non-refractory viral warts

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 QUESTION: In healthy people with clinically observed viral warts, are common topical treatments or cryotherapy more effective than placebo or no treatment for improving clinical cure?

Data sources

Studies were identified by searching electronic databases that included Medline (1966 to May 2000), EMBASE/Excerpta Medica (1980 to August 2000), and CINAHL (1982 to March 1999); hand searching 8 relevant journals; and by reviewing bibliographies of relevant articles. Experts in the field and pharmaceutical companies were contacted for unpublished studies.

Study selection

Studies in any language were selected if they were randomised controlled trials (RCTs) of local treatments (all topical, intralesional, and surgical treatments, including cryotherapy but not systemic or psychological treatments) in people with clinically observed non-genital viral warts.

Data extraction

Data were extracted on study setting, sample size, key components of the intervention, study quality and outcomes. The main outcome was clinical cure (defined as complete disappearance of elevated/warty skin) at the end of a treatment period.

Main results

50 RCTs met the selection criteria. Meta-analyses were done using random effects models. (1) Simple topical agents containing salicylic acid and/or lactic acid for 6–12 weeks (13 RCTs): meta-analysis …

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  • For correspondence: Dr S Gibbs, Ipswich Hospital NHS Trust, Ipswich, UK. sgibbs{at}

  • Source of funding: Norfolk Health Authority UK.