Eficacy and tolerability of nitric-zinc complex in the treatment of external genital warts and "dificult-To-Treat" warts

A "proof of concept", prospective, multicentre, open study

M. Cusini, G. Micali, F. Lacarrubba, M. Puviani, A. Barcella, M. Milani

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Aim. Treatment of plantar and periungueal warts (so called "dificult-To-Treat" warts, DTW) and external genital warts (EGW) remains unsatisfactory. Medical or invasive procedures are partially effective and/or painful. Furthermore recurrences rates after treatments are still a relevant problem for all the available therapies. Nitric-zinc complex is a solution for topical application containing nitric acid, zinc, copper and organic acids able to induce a caustic effect of the wart trough mummiication and proteins denaturation/ coagulation action. Nitric-zinc complex has been shown to be an effective and well tolerated treatment of common warts. Methods. We evaluated in a prospective open label 4-centre trial, the eficacy and local tolerability of nitric-zinc complex in the treatment of EGW and DTW. A total of 37 immunocompetent subjects (20 men and 17 women; mean age: 45 years) with single or multiple lesions, were enrolled, after their informed consent. A total of 30 subjects had EGW, 2 subjects had plantar warts, 2 warts of the hand and 3 periungueal lesions. Nitric-zinc aqueous solution was applied topically using a 30 μL capillary tube over the lesions until a whitening/yellowish reaction appeared. A second (or more, if needed) application was performed at two-week interval until a complete clinical cure rate was observed. Primary outcome of the study was the clinical evaluation with picture documentation of the evolution of lesions classiied as total cure, partial disappearance or no effect. Topical tolerability was evaluated through patient's reported adverse events. Results. All subjects completed the study. A complete cure of lesions was observed in 31 subjects (90%) after one and up to four applications. Three patients with EGW (8%) showed a partial disappearance of lesions and one (2%) subject was no responder to four nitric-zinc complex applications. The product was well tolerated. No serious adverse events were observed or recorded. Conclusion. Nitric-zinc complex topical solution has shown to be an effective and well tolerated treatment of EGW and "dificult-To-Treat" warts with a 90% of subjects with a total cure after one or up to four applications. A total or partial response was observed in 99% of the subjects. Nitric-zinc complex could be considered an easy-To-use effective treatment strategy of "dificult-To-Treat" warts and external genital warts. Additional studies comparing nitric-zinc complex to other strategies are warranted.

Original languageEnglish
Pages (from-to)643-648
Number of pages6
JournalGiornale Italiano di Dermatologia e Venereologia
Volume150
Issue number6
Publication statusPublished - 2015

Fingerprint

Condylomata Acuminata
Warts
Multicenter Studies
Zinc
Therapeutics
Protein Denaturation
Nitric Acid
Caustics
Informed Consent
Documentation
Copper
Hand
Outcome Assessment (Health Care)
Recurrence
Acids

Keywords

  • Nitric acid
  • Warts
  • Zinc

ASJC Scopus subject areas

  • Dermatology

Cite this

Eficacy and tolerability of nitric-zinc complex in the treatment of external genital warts and "dificult-To-Treat" warts : A "proof of concept", prospective, multicentre, open study. / Cusini, M.; Micali, G.; Lacarrubba, F.; Puviani, M.; Barcella, A.; Milani, M.

In: Giornale Italiano di Dermatologia e Venereologia, Vol. 150, No. 6, 2015, p. 643-648.

Research output: Contribution to journalArticle

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title = "Eficacy and tolerability of nitric-zinc complex in the treatment of external genital warts and {"}dificult-To-Treat{"} warts: A {"}proof of concept{"}, prospective, multicentre, open study",
abstract = "Aim. Treatment of plantar and periungueal warts (so called {"}dificult-To-Treat{"} warts, DTW) and external genital warts (EGW) remains unsatisfactory. Medical or invasive procedures are partially effective and/or painful. Furthermore recurrences rates after treatments are still a relevant problem for all the available therapies. Nitric-zinc complex is a solution for topical application containing nitric acid, zinc, copper and organic acids able to induce a caustic effect of the wart trough mummiication and proteins denaturation/ coagulation action. Nitric-zinc complex has been shown to be an effective and well tolerated treatment of common warts. Methods. We evaluated in a prospective open label 4-centre trial, the eficacy and local tolerability of nitric-zinc complex in the treatment of EGW and DTW. A total of 37 immunocompetent subjects (20 men and 17 women; mean age: 45 years) with single or multiple lesions, were enrolled, after their informed consent. A total of 30 subjects had EGW, 2 subjects had plantar warts, 2 warts of the hand and 3 periungueal lesions. Nitric-zinc aqueous solution was applied topically using a 30 μL capillary tube over the lesions until a whitening/yellowish reaction appeared. A second (or more, if needed) application was performed at two-week interval until a complete clinical cure rate was observed. Primary outcome of the study was the clinical evaluation with picture documentation of the evolution of lesions classiied as total cure, partial disappearance or no effect. Topical tolerability was evaluated through patient's reported adverse events. Results. All subjects completed the study. A complete cure of lesions was observed in 31 subjects (90{\%}) after one and up to four applications. Three patients with EGW (8{\%}) showed a partial disappearance of lesions and one (2{\%}) subject was no responder to four nitric-zinc complex applications. The product was well tolerated. No serious adverse events were observed or recorded. Conclusion. Nitric-zinc complex topical solution has shown to be an effective and well tolerated treatment of EGW and {"}dificult-To-Treat{"} warts with a 90{\%} of subjects with a total cure after one or up to four applications. A total or partial response was observed in 99{\%} of the subjects. Nitric-zinc complex could be considered an easy-To-use effective treatment strategy of {"}dificult-To-Treat{"} warts and external genital warts. Additional studies comparing nitric-zinc complex to other strategies are warranted.",
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year = "2015",
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TY - JOUR

T1 - Eficacy and tolerability of nitric-zinc complex in the treatment of external genital warts and "dificult-To-Treat" warts

T2 - A "proof of concept", prospective, multicentre, open study

AU - Cusini, M.

AU - Micali, G.

AU - Lacarrubba, F.

AU - Puviani, M.

AU - Barcella, A.

AU - Milani, M.

PY - 2015

Y1 - 2015

N2 - Aim. Treatment of plantar and periungueal warts (so called "dificult-To-Treat" warts, DTW) and external genital warts (EGW) remains unsatisfactory. Medical or invasive procedures are partially effective and/or painful. Furthermore recurrences rates after treatments are still a relevant problem for all the available therapies. Nitric-zinc complex is a solution for topical application containing nitric acid, zinc, copper and organic acids able to induce a caustic effect of the wart trough mummiication and proteins denaturation/ coagulation action. Nitric-zinc complex has been shown to be an effective and well tolerated treatment of common warts. Methods. We evaluated in a prospective open label 4-centre trial, the eficacy and local tolerability of nitric-zinc complex in the treatment of EGW and DTW. A total of 37 immunocompetent subjects (20 men and 17 women; mean age: 45 years) with single or multiple lesions, were enrolled, after their informed consent. A total of 30 subjects had EGW, 2 subjects had plantar warts, 2 warts of the hand and 3 periungueal lesions. Nitric-zinc aqueous solution was applied topically using a 30 μL capillary tube over the lesions until a whitening/yellowish reaction appeared. A second (or more, if needed) application was performed at two-week interval until a complete clinical cure rate was observed. Primary outcome of the study was the clinical evaluation with picture documentation of the evolution of lesions classiied as total cure, partial disappearance or no effect. Topical tolerability was evaluated through patient's reported adverse events. Results. All subjects completed the study. A complete cure of lesions was observed in 31 subjects (90%) after one and up to four applications. Three patients with EGW (8%) showed a partial disappearance of lesions and one (2%) subject was no responder to four nitric-zinc complex applications. The product was well tolerated. No serious adverse events were observed or recorded. Conclusion. Nitric-zinc complex topical solution has shown to be an effective and well tolerated treatment of EGW and "dificult-To-Treat" warts with a 90% of subjects with a total cure after one or up to four applications. A total or partial response was observed in 99% of the subjects. Nitric-zinc complex could be considered an easy-To-use effective treatment strategy of "dificult-To-Treat" warts and external genital warts. Additional studies comparing nitric-zinc complex to other strategies are warranted.

AB - Aim. Treatment of plantar and periungueal warts (so called "dificult-To-Treat" warts, DTW) and external genital warts (EGW) remains unsatisfactory. Medical or invasive procedures are partially effective and/or painful. Furthermore recurrences rates after treatments are still a relevant problem for all the available therapies. Nitric-zinc complex is a solution for topical application containing nitric acid, zinc, copper and organic acids able to induce a caustic effect of the wart trough mummiication and proteins denaturation/ coagulation action. Nitric-zinc complex has been shown to be an effective and well tolerated treatment of common warts. Methods. We evaluated in a prospective open label 4-centre trial, the eficacy and local tolerability of nitric-zinc complex in the treatment of EGW and DTW. A total of 37 immunocompetent subjects (20 men and 17 women; mean age: 45 years) with single or multiple lesions, were enrolled, after their informed consent. A total of 30 subjects had EGW, 2 subjects had plantar warts, 2 warts of the hand and 3 periungueal lesions. Nitric-zinc aqueous solution was applied topically using a 30 μL capillary tube over the lesions until a whitening/yellowish reaction appeared. A second (or more, if needed) application was performed at two-week interval until a complete clinical cure rate was observed. Primary outcome of the study was the clinical evaluation with picture documentation of the evolution of lesions classiied as total cure, partial disappearance or no effect. Topical tolerability was evaluated through patient's reported adverse events. Results. All subjects completed the study. A complete cure of lesions was observed in 31 subjects (90%) after one and up to four applications. Three patients with EGW (8%) showed a partial disappearance of lesions and one (2%) subject was no responder to four nitric-zinc complex applications. The product was well tolerated. No serious adverse events were observed or recorded. Conclusion. Nitric-zinc complex topical solution has shown to be an effective and well tolerated treatment of EGW and "dificult-To-Treat" warts with a 90% of subjects with a total cure after one or up to four applications. A total or partial response was observed in 99% of the subjects. Nitric-zinc complex could be considered an easy-To-use effective treatment strategy of "dificult-To-Treat" warts and external genital warts. Additional studies comparing nitric-zinc complex to other strategies are warranted.

KW - Nitric acid

KW - Warts

KW - Zinc

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VL - 150

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EP - 648

JO - Minerva dermatologica

JF - Minerva dermatologica

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