From the Guidelines
For a teenager with Crohn's disease on immunosuppressants who has verrucas (plantar warts), the most appropriate initial treatment approach is the use of salicylic acid preparations, as it is a safer option that can help reduce wart bulk without causing significant damage to the surrounding skin. According to the British Association of Dermatologists' guidelines for the management of cutaneous warts 1, standard treatments with paring, abrasive agents, salicylic acid, and destructive methods can help reduce wart size and alleviate functional and cosmetic problems in immunosuppressed patients.
Key Considerations
- The treatment may not result in a cure but can help manage symptoms 1.
- It is crucial to avoid damaging the surrounding skin, as this can lead to the spread of infection 1.
- Cryotherapy can be used but should be applied cautiously due to potential pain and blistering 1.
- Aggressive treatments like surgical removal, laser therapy, or strong acids should be avoided due to the risk of poor wound healing in immunosuppressed patients.
Treatment Options
- Salicylic acid (15–40%) topical paints or ointments 1.
- Cryotherapy, gentle, fortnightly for 3–4 months 1.
- Other treatments like cidofovir, formaldehyde solution or gel, glutaraldehyde 10% solution, laser, silver nitrate, systemic retinoids, and topical immunotherapy may be considered but should be approached with caution and under the guidance of a dermatologist 1.
Important Precautions
- Consultation with both the gastroenterologist managing the Crohn's disease and a dermatologist is essential before starting any treatment [no specific reference, general medical knowledge].
- The patient should avoid picking at the warts and keep them covered in public areas to prevent spread [no specific reference, general medical knowledge].
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Verruca Treatment for Teenager with Crohn's on Immunosuppressants
- There are no research papers directly addressing the treatment of verruca in teenagers with Crohn's disease who are on immunosuppressants.
- However, studies have investigated the use of immunosuppressants in Crohn's disease, which may provide some insight into the potential interactions between immunosuppressants and verruca treatment 2, 3, 4, 5, 6.
- Immunosuppressants, such as azathioprine and 6-mercaptopurine, are commonly used to treat Crohn's disease, and have been shown to be effective in reducing steroid requirements and healing fistulas 4.
- Biologics, such as infliximab and adalimumab, have also been shown to be effective in inducing and maintaining remission in Crohn's disease, and may be used in combination with immunosuppressants 5.
- The perioperative use of immunosuppressive medications in patients with Crohn's disease is a concern, as it may increase the risk of postoperative infectious complications and affect anastomotic healing 6.
- It is essential to consider the potential interactions between immunosuppressants and verruca treatment, and to consult with a healthcare professional to determine the best course of treatment for a teenager with Crohn's disease who is on immunosuppressants.