SEVERE BULLOUS REACTION TO AN OVER THE COUNTER TOPICAL SALICYLIC ACID-LACTIC ACID SOLUTION USED TO TREAT RECALCITRANT PLANTAR WARTS REACŢIE BULOASĂ SEVERĂ LA APLICAREA UNEI SOLUŢII PE BAZĂ DE ACID SALICILIC ŞI ACID LACTIC PENTRU TRATAREA VERUCILOR PLANTAR

Lawrence Chukwudi Nwabudike, Claudina Cobzariu, Alin Laurentiu Tatu

Abstract


Background : Plantar warts are a common cutaneous disorder of viral origin. There are many treatment modalities for this disorder. The purpose of this paper was to present the case a 12-year old boy, brought by his mother for a 3-day history of pain and swelling of the left foot, following the application of a topical, over- the-counter solution containing salicylic and lactic acids. Our goal was to establish a treatment to control the disease.

Materials and methods: Examination revealed a hyperkeratotic, multiloculated lesion, with underlying bullae on the anterior left sole, associated with an erythematous streak of lymphangitis going up to his leg. Results: The bulla was excised and the resulting wound treated with topical povidon iodine solution, which the patient was instructed to apply daily.
The patient was also recommended amoxicillin-clavulanic acid combination and he improved. Finally, the patient was treated with a cream containing a hyaluronic acid-sulphadiazine cream, which completed the healing process. Conclusions: There are many treatment modalities for plantar warts. The salicylic-lactic acid solution used by this patient was containing 167 mg/mL of each active ingredient. Care must therefore be exercised in the treatment of patients and in informing patients, who may apply the low concentration, over the counter topical salicylic acid in the full belief they are safe from side effects. 

Introducere : Verucile plantare sunt infecţii cutanate virale frecvente. Există multiple alternative terapeutice pentru această afecţiune.Această lucrare prezintă cazul unui pacient în vârstă de 12 ani, care se prezintă pentru o leziune dureroasă, edematoasă la nivel plantar, debutată în urma aplicării unei soluţii pe bază de acid salicilic şi acid lactic. Scopul autorilor a fost stabilirea unei conduite terapeutice adecvate.

Materiale şi metode: Examenul clinic a evidenţiat prezenţa unei leziuni hiperkeratozice, multiloculate, cu bulă periferică la nivelul plantar, asociată cu prezenţa unei benzi ascendente de limfangită.
Rezultate: Bula a fost excizată, iar rana rezultată, tratată cu soluţie iodată zilnic. Pacientului i-a fost de asemenea recomandat tratament sistemiccu amoxicilină şi acid clavulanic, cu evoluţie favorabilă. În cele din urmă, pacientul a fost tratat cu o cremă conținând acid-sulfadiazină, urmată de vindecarea completă a leziunii.
Concluzii: Există multiple metode de a tratata verucile plantare. Soluţia
pe bază de acizi salicilic-lactic utilizată de pacient conţinea 167 mg/ml
din fiecare acis. Este necesar ca pacienţii să primească instrucţiuni clare
cu privire la modul de aplicare al acestora, precum şi recomandarea de a utiliza soluţiile în concentraţii mai mici.


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