The authors have no acknowledgments.

Informed consent was obtained from all participants and the treatment protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University.
1. Patient selection
<ol>
	<li>Use the following inclusion criteria to include patients who show a clear diagnosis of HPV infection in a common wart, plantar wart, or condyloma acuminatum; the product is indicated for patients who are capable of adhering to medical advice provided by their h...

Effective Wart Treatment with Local Hyperthermia: A Minimally Invasive Approach

<ol>
	<li>White, E. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Manipulation+of+epithelial+differentiation+by+HPV+oncoproteins.">Manipulation of epithelial differentiation by HPV oncoproteins.</a> Viruses. 11 (4), 369 (2019).</li><li>Witchey, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plantar+warts:+Epidemiology,+pathophysiology,+and+clinical+management.">Plantar warts: Epidemiology, pathophysiology, and clinical management.</a> J Osteo Med. 118 (2), 92-105 (2018).</li><li>Burli, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HPV+vaccination+status+and+resolution+of+warts+in+pediatric+patients.">HPV vaccination status and resolution of warts in pediatric patients.</a> Indian J Dermatol. 66 (6), 604-608 (2021).</li><li>Lofty, A. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intralesional+combined+furosemide+and+digoxin+in+cutaneous+warts+treatment:+A+randomized+controlled+clinical+trial.">Intralesional combined furosemide and digoxin in cutaneous warts treatment: A randomized controlled clinical trial.</a> Derma Ther. 35 (12), e15935 (2022).</li><li>Garc&#237;a-Oreja, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Topical+treatment+for+plantar+warts:+A+systematic+review.">Topical treatment for plantar warts: A systematic review.</a> Derma Ther. 34 (1), e14621 (2021).</li><li>Fields, J. R., Saikaly, S. K., Schoch, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intralesional+immunotherapy+for+pediatric+warts:+A+review.">Intralesional immunotherapy for pediatric warts: A review.</a> Pedia Derma. 37 (2), 265-271 (2020).</li><li>Zhang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Amplifying+cancer+treatment:+advances+in+tumor+immunotherapy+and+nanoparticle-based+hyperthermia.">Amplifying cancer treatment: advances in tumor immunotherapy and nanoparticle-based hyperthermia.</a> Front Immunol. 14, 1258786 (2023).</li><li>Chen, J. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Successful+treatment+of+extensive+flat+warts+with+local+hyperthermia:+A+case+report.">Successful treatment of extensive flat warts with local hyperthermia: A case report.</a> Derma Ther. 33 (6), e14525 (2020).</li><li>De Planell-Mas, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+papillomaviruses+genotyping+in+plantar+warts.">Human papillomaviruses genotyping in plantar warts.</a> J Med Virol. 4689 (5), 902-907 (2017).</li><li>Li, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Local+hyperthermia+could+induce+migrational+maturation+of+Langerhans+cells+in+condyloma+acuminatum.">Local hyperthermia could induce migrational maturation of Langerhans cells in condyloma acuminatum.</a> J Dermatol Sci. 54, 121-123 (2009).</li><li>Huo, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clearance+of+genital+warts+in+pregnant+women+by+mild+local+hyperthermia:+a+pilot+report.">Clearance of genital warts in pregnant women by mild local hyperthermia: a pilot report.</a> Dermatol Ther. 27, 109-112 (2014).</li><li>Hildebrandt, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+cellular+and+molecular+basis+of+hyperthermia.">The cellular and molecular basis of hyperthermia.</a> Crit Rev Oncol Hematol. 43, 33-56 (2002).</li><li>Huo, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Local+hyperthermia+at+44+&#176;C+for+the+treatment+of+plantar+warts:+a+randomized,+patient-blinded,+placebo-controlled+trial.">Local hyperthermia at 44 &#176;C for the treatment of plantar warts: a randomized, patient-blinded, placebo-controlled trial.</a> J Infect Dis. 201 (8), 1169-1172 (2010).</li><li>Chen, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+observation+and+study+of+local+hyperthermia+for+treating+plantar+warts:+A+pilot+study+with+38+patients.">Clinical observation and study of local hyperthermia for treating plantar warts: A pilot study with 38 patients.</a> Front Medi. 10, 1087659 (2023).</li><li>Qi, R. Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clearance+of+multiple+cutaneous+warts+by+targeting+a+single+lesion:+A+randomized+comparative+evaluation+of+mild+local+hyperthermia+versus+cryotherapy.">Clearance of multiple cutaneous warts by targeting a single lesion: A randomized comparative evaluation of mild local hyperthermia versus cryotherapy.</a> J Am Acad Dermatol. 87 (6), 1443-1445 (2022).</li><li>Garcia-Oreja, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Topical+treatment+for+plantar+warts:+a+systematic+review.">Topical treatment for plantar warts: a systematic review.</a> Dermatol Ther. 34, e14621 (2021).</li><li>Lipke, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+armamentarium+of+wart+treatments.">An armamentarium of wart treatments.</a> Clin Med Res. 4 (4), 273-293 (2006).</li><li>Forcier, M., Musacchio, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+overview+of+human+papillomavirus+infection+for+the+dermatologist:+disease,+diagnosis,+management,+and+prevention.">An overview of human papillomavirus infection for the dermatologist: disease, diagnosis, management, and prevention.</a> Derma Ther. 23 (5), 458-476 (2010).</li><li>Stern, P., Levine, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Controlled+localized+heat+therapy+in+cutaneous+warts.">Controlled localized heat therapy in cutaneous warts.</a> Arch Dermatol. 128 (7), 945-948 (1992).</li><li>Pfau, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nd:YAG+laser+hyperthermia+in+the+treatment+of+recalcitrant+verrucae+vulgares+(Regensburg's+technique).">Nd:YAG laser hyperthermia in the treatment of recalcitrant verrucae vulgares (Regensburg's technique).</a> Acta Dermato-Venereologica. 74 (3), 212-214 (1994).</li><li>Huo, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Local+hyperthermia+versus+cryotherapy+for+treatment+of+plantar+warts:+A+prospective+multi-centre+non-randomized+concurrent+controlled+clinical+trial.">Local hyperthermia versus cryotherapy for treatment of plantar warts: A prospective multi-centre non-randomized concurrent controlled clinical trial.</a> Acta Dermato-Venereologica. 102, adv00655 (2022).</li><li>Yoshioka, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Suppression+of+contact+sensitivity+by+local+hyperthermia+treatment+due+to+reduced+Langerhans+cell+population+in+mice.">Suppression of contact sensitivity by local hyperthermia treatment due to reduced Langerhans cell population in mice.</a> British J Dermatol. 120 (4), 493-501 (1989).</li><li>Jiang, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Successful+treatment+of+periungual+warts+with+local+hyperthermia:+report+of+two+cases.">Successful treatment of periungual warts with local hyperthermia: report of two cases.</a> J Dermatolog Treat. 33 (4), 2380-2382 (2022).</li><li>Huo, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clearance+of+genital+warts+in+pregnant+women+by+mild+local+hyperthermia:+a+pilot+report.">Clearance of genital warts in pregnant women by mild local hyperthermia: a pilot report.</a> Derma Ther. 27 (2), 109-112 (2014).</li><li>Zhao, S. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multicenter+realworld+observation+to+evaluate+the+efficacy+of+cryotherapy+versus+local+hyperthermia+for+the+treatment+of+plane+warts.">A multicenter realworld observation to evaluate the efficacy of cryotherapy versus local hyperthermia for the treatment of plane warts.</a> Derma Ther. 35 (5), e15403 (2022).</li></ol>

The authors have no conflicts of interest to declare.

Plantar warts, condylomata acuminata, and common warts all include mucocutaneous manifestations resulting from human papillomavirus (HPV) infection; these lesions can present as solitary skin lesions or, more commonly, as multiple lesions17.
In the continuous effort to manage warts induced by Human Papillomavirus (HPV), a diverse array of therapeutic strategies has been implemented. These include destructive methods, virucidal agents, antimitotic compounds, and immunoth...

Warts, which are benign epidermal proliferations, are a direct result of human papillomavirus (HPV) infection, specifically targeting the keratinocytes within the stratum corneum of the skin1. They are most commonly manifested clinically as the formation of warts, including plantar warts, genital warts, and common warts2. Warts are typically benign in nature, and although they are occasionally subject to spontaneous resolution3, a considerable number of individuals prefer to have them excised primarily due to the discomfort they cause or social embarrassment4.
A variety of therapeutic approaches have been employed to treat warts, including laser therapy, antiviral treatments, antimitotic medications, and immunotherapies5. However, these treatments are often accompanied by adverse effects such as pain, bleeding, secondary infections, and ulceration6. Consequently, there exists an urgent demand for treatment modalities that offer enhanced safety, efficacy, and minimal invasiveness, particularly for special populations, including the elderly, children, and pregnant women, as well as for specific anatomic sites such as the perianal region and the vulva. 
Addressing the demand for effective and minimally invasive treatments, local hyperthermia has emerged as a promising therapeutic strategy. Hyperthermia has been effectively utilized in the treatment of certain neoplasms7, and there are numerous studies that have demonstrated the efficacy of localized hyperthermia in the management of warts, yielding highly satisfactory outcomes8,9. The hyperthermia device used here offers a range of customizable settings, including adjustable levels and modes, designed to meet diverse therapeutic needs. The overall goal of this hyperthermia device is to provide a non-invasive, safe, and efficacious approach for wart management that is suitable for a wide range of patient populations, including those who are not candidates for more invasive procedures. 
This technique of using local hyperthermia for HPV-related warts is positioned within a growing body of literature that explores the role of heat in modulating immune cell function. It builds on a previous study that established the importance of Langerhans cells in the immune response to skin infections and how their balance can be restored through controlled heat application10.
Individuals with diagnosed HPV-related warts, such as common, plantar, or genital, and who are compliant with medical guidance are considered appropriate candidates for local hyperthermia treatment. Although pregnancy is not an absolute contraindication, pregnant patients must be made aware of the associated risks and must provide informed consent to proceed11. This treatment is not recommended for those with periocular lesions, purulent infections, a propensity for severe scarring, coagulation disorders, or known photosensitivity. Additionally, patients with warts in proximity to tumors are not candidates, as this could suggest an underlying neoplastic process.

<table>
	<tbody>
		<tr>
			<td>YY-WRY-V02 infrared specific wave photothermal therapeutic instrument</td>
			<td>Liaoning Yanyang Medical Equipment Co., Ltd</td>
			<td>No. ZL200720185403.3, China Medical University, China)</td>
			<td></td>
		</tr>
	</tbody>
</table>

local hyperthermia for warts treatment

Warts, benign epidermal proliferations, are a direct result of human papillomavirus (HPV) infection, specifically targeting the keratinocytes within the stratum corneum of the skin. The development of warts is the most common clinical manifestation of HPV, with plantar warts, condylomata acuminata, and common warts being the most frequently observed types. These growths can be unsightly and sometimes painful, affecting the quality of life for those afflicted. Although various treatments are available, ranging from topical medications to surgical procedures, the quest for a treatment that is both safe and effective while minimizing invasiveness continues. This is particularly crucial for populations with heightened risk factors, such as immuno-compromised individuals. In the clinical need for minimally invasive treatments, local hyperthermia has emerged as a promising therapeutic strategy for wart management. As demonstrated in various studies, local hyperthermia is effective as a standalone treatment, offering a valuable alternative for patients seeking less intrusive therapeutic options.

Author Spotlight: Dermatopathology and the Treatment of Sexually Transmitted Diseases

Local Hyperthermia for Warts Treatment

My research focuses on using local hyperthermia for wart treatment. The goals of my study are to determine whether this method is more effective than traditional treatments. Identify the optimal treatment parameters for safety and efficacy, and evaluate its impact on recurrence rates.Clarifying the mechanisms of action for local hyperthermia treatment. Optimizing temperature based on the thickness and number of skin lesions, ensuring constant treatment, in fact. Further, exploring therapeutic principles and accessing long-term impacts on skin health.In dermatology and sexual transmitted disease, we've established that local hyperthermia is an effective treatment for HPV related warts with a high success rate and minimal side effects. Our team will explore how local hyperthermia works, improve treatment for skin issues, and see if combining it with other therapies boosts its power. We also want to learn about its long-term skin impact and use in unique patient groups.

Multiple hospitals have contributed to a series of investigations into the therapeutic effects of hyperthermia. This research encompasses single-arm clinical observational studies, placebo-controlled trials, and comparative analyses with cryotherapy, with the findings being published in various articles13,14,15. They found that hyperthermia was also associated with reduced pain during treatment h...

Here, we present a protocol for local hyperthermia, a new and effective therapeutic for treating warts. We also showcase its safety and efficacy as an independent treatment.

Warts, benign epidermal proliferations, are a direct result of human papillomavirus (HPV) infection, specifically targeting the keratinocytes within the ...

Research

JoVE Journal

Behavior

Procedure for Hyperthermia Treatment for HPV-Related Warts

After selecting the target skin lesion, turn on the power switch to start the machine. Once powered on, wait for the display to appear on the machine's operating screen. Then, access the registration form by navigating to the registration module within the interface.Enter the patient's basic details, including name, gender, age, skin lesion location, skin lesion size, and number of lesions into the respective fields. Now, click the capture or photo button on the screen to take an image of the lesion. Select the desired temperature level from nine available levels ranging from 40 degrees Celsius at level one to 46 degrees Celsius at level nine.Based on the patient's condition and treatment plan, choose the appropriate treatment mode from the provided options. Set the irradiation duration to a minimum of 30 minutes for the session. Then, guide the patient into a comfortable and stable position that allows effective discomfort-free treatment.Adjust the mechanical arm manually to coarsely position it for the procedure. Use the manual controls to position the mechanical arm roughly over the treatment area, ensuring it is in the correct general vicinity. Fine tune the mechanical arm using the cross switch for precise alignment.Now, click the start button on the screen to initiate the irradiation process. During treatment, assess the patient's comfort every two to three minutes and adjust the treatment intensity as needed to ensure safety. Instruct the patient to use the bedside call bell for any discomfort.If patient movement affects the treatment focus, the device will trigger an alarm. Upon hearing the alarm, promptly attend to the patient to assist with repositioning. Once focus is regained, the machine will automatically continue the treatment.Monitor the remaining treatment time displayed on the control panel throughout the procedure. When the set duration ends, the control panel will automatically switch back to the main interface, indicating that the session is complete. After the treatment, reset the mechanical arm to its original position.Ensure the arm is fully retracted and ready for the next session or storage.

276 Views.  The First Affiliated Hospital of Chongqing Medical University.  Here, we present a protocol for local hyperthermia, a new and effective therapeutic for treating warts. We also showcase its safety and efficacy as an independent treatment.

Effective Wart Treatment with Local Hyperthermia: A Minimally Invasive Approach

Summary