Histopathological evaluation of Nd: YAG laser versus Tuberculin Purified Protein Derivative in treatment of palmoplantar warts.

Hanafy, Noha S; Eladel, Rasha; Salah, Manal; AbdelHamid, Mahmoud Fawzi; Ashoush, Riham Nabil; Gohdan, Noha AbdAllah; Soliman, Mohamed Mohsen

doi:10.21608/jlsa.2025.364275.1031

Histopathological evaluation of Nd: YAG laser versus Tuberculin Purified Protein Derivative in treatment of palmoplantar warts.

Document Type : Original Article

Authors

¹ National research centre

² Assistant researcher of Dermatology, Department of Dermatology and Venereology, Medical Research and Clinical Studies Institute, National Research Centre, NRC.

³ Medical Applications of laser Dept., National Institute of Laser Enhanced Sciences, Cairo University. Egypt.

⁴ Professor of Dermatology, Department of Dermatology and Venereology, Medical Research and Clinical Studies Institute, National Research Centre, NRC. Giza, Egypt.

⁵ Researcher of Dermatology, Department of Dermatology and Venereology, Medical Research and Clinical Studies Institute, National Research Centre, NRC. Egypt.

⁶ Lecturer, Department of Medical Applications of Laser, Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt

⁷ Associate Professor of Dermatology, Department of medical applications of Laser, National Institute of Laser Enhanced Sciences, (NILES).Egypt.

10.21608/jlsa.2025.364275.1031

Abstract

Background
Warts, caused by HPV, exhibit hyperkeratosis, papillomatosis, and Koilocytes histopathologically. Nd: YAG laser provides photothermal destruction, while PPD offers an immunotherapeutic approach for treating palmoplantar warts.

Purpose:
To compare the histopathological effects of Nd: YAG laser monotherapy versus Tuberculin PPD in treating palmoplantar warts.

Methods:
Sixteen patients were divided into two groups: one received Nd: YAG laser sessions every 4 weeks (4 sessions), while the other received intralesional PPD every 2 weeks (6 sessions). Biopsies were taken before and after treatment (4 months). Histopathological analysis was performed using H&E and p16 immunohistochemistry.

Results:
In the Nd: YAG group, koilocyte count significantly decreased from 142.67±55.4 to 24.5±42.1 (p < 0.028), whereas PPD treatment showed a nonsignificant reduction (143.5±50.2 to 130.3±80.0, p = 0.753). Rete ridge elongation significantly reduced in the Nd: YAG group (17.83±6.6 to 8.17±8.8, p < 0.027) but not in the PPD group (p = 0.115). p16 expression also significantly decreased with Nd: YAG (54.39±4.6 to 13.9±16.4, p = 0.028), while PPD had a nonsignificant effect.

Conclusion:
Nd: YAG laser was more effective than PPD in reducing koilocytes, rete ridges, and p16 expression.

Keywords