A randomized controlled trial analyzing nonthermal atmospheric plasma for the treatment of verruca vulgaris in pediatric patients.

Background: Verruca vulgaris (VV) is a common viral disease in children. Treatment options are often not well tolerated in children due to pain or adverse effect risk. Nonthermal atmospheric plasma (NTAP), which generates reactive oxygen/nitrogen species, is well tolerated and without adverse effects.

Objective: Determine efficacy of NTAP as compared to standard of care (SOC) therapy for VV in children.

Methods: This prospective open-label study randomized lesions 1:1 to receive NTAP or SOC (cryotherapy). Patients were treated at 4-week intervals for a maximum of 3 treatments. They were evaluated 4 weeks postfinal treatment for sustained response. Primary outcome was lesion response.

Results: One hundred twelve VV lesions in 14 patients were enrolled. Patients were mostly White (92.9%) males (71.4%) with mean age of 9.5 [±2.5] years. Responses of SOC- and NTAP-treated lesions, respectively, included no response (5.4%, 7.1%); partial response (33.9%, 41.1%); and complete resolution (60.7%, 51.8%; P value = .679). Patients were more likely to report pain in SOC lesions post-treatment (P value <.001). No significant adverse events (AEs) occurred.

Limitations: Limitations include single-site, maximum of 3 treatments, and short post-treatment follow-up.

Conclusion: NTAP is an efficacious, safe intervention for treatment of VV in children.