II. Indications
- Recalcitrant warts
- Basal Cell Carcinoma
III. Precautions
- Risk for painful scars (even by experienced Doctor)
- Lesions larger than 1 cm should be excised instead
IV. Precautions
- Wear a well-fitted mask (that filters HPV)
- Prevents verrucous laryngeal papillomas (rare)
- Can result in Squamous Cell Carcinoma
- Smoke evacuators also recommended
- Prevents verrucous laryngeal papillomas (rare)
- Undertreat
- Avoids painful scarring
V. Technique
- Use Local Anesthesia
- Use mask and smoke evacuation as described above
- Insert electric needle into the wart
- Apply low-medium current for 5-10 seconds
- Until wart whitens and becomes boggy
- Follow current with Light curettage
- Coagulate bleeding with pressure and 88% TCA
- Residual wart tissue appears as blanched, punctate
VI. Follow-up
- Apply Topical Antibiotic ointment and dressing
- Postoperative pain is less than with Cryotherapy