January 6, 1999
From: John W. M.D., P.C., Washington
RE: Use of Cytolog for Treatment of Plantar Warts
To Whom It May Concern:
Please be advised that I had occasion to see a patient for untreated plantar warts. On initial evaluation she had quite severe involvement primarily on the one foot, although the other was also involved with fewer scattered lesions. On the foot with the most severe condition, she had two primary clusters of warts, one cluster measuring about 1.5 cm in diameter, the other measuring about 7 mm in diameter, each being made up of numerous warts. In addition, she had other more scattered lesions, some large and some small.
We initially did one session of cryotherapy with debridgement, and on the second visit, considering the options, and the extent of the condition, I decided that a trial of Cytolog may well be worthwhile, although apparently there had been no previous case reports.
I advised the patient to apply the Cytolog spray orally as well as directly into the sole of each foot after she had roughened up the skin with an emery board.
She came in to see me two weeks later, reporting the warts had started to turn black by about 5-7 days, and in fact on closer inspection, the warts looked somewhat opaque and all of them had thrombosed vasculature evident, suggesting they were already in a gangrenous state. Debridgement on that first visit showed that the lesions were in fact necrotic, and in fact one lesion seemed to simply shell out of its "nest" leaving a crater in the epidermis.
The patient was rechecked two weeks later after continuing the same protocol for that time, and lesions were unchanged. They continued to be necrotic, again debridgement was carried out and more of the lesions simply shelled out.
At this time the patient has stopped the protocol and we will be observing closely for recurrence.
At this point, I must say that this would represent a rather radical therapy since conventional means would have undoubtedly required a messy surgical excision or a very lengthy (8-12 months) duration of either cryotherapy or chemical therapy.
It is likely that therapeutic goals had already been achieved by the first week when the patient first noticed the vasculature of the lesions to be blackened and thrombosed. Further observation will be carried out with subsequent cases.
John A. W... M. D.
(Full names have been abbreviated for privacy)