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01/14/2012
RESPONSES/COMMENTS (CLINICAL )
From: Sloan Gordon, DPM
You may want to try cimetadine 20mg/kg per day in divided doses (I generally use BID). I'm not sure that you will find the liquid anymore as this is an OTC product. I have had some success with topical antivirals such as acycylovir, applied QID. There are some other medications that are topical anti-inflammatories that work, but I think you're on the right path. I would not freeze the warts as they may just subside on their own by keeping the feet clean and dry with a topical humectant (powder or corn starch).
Other messages in this thread:
01/13/2012
RESPONSES/COMMENTS (CLINICAL )
From: Tip Sullivan, DPM
I have used cimetadine as an ancillary treatment for warts for at least 15 years in children and adults (20mg/kg/day in children, and up to 40mg/kg/day in adults). Anecdotally, I have seen varied responses from resolution within one month of multiple warts, to no effect. I have not been able to differentiate between who will be helped and who will not. Since it is a relatively benign drug, and it requires daily dosing which may add to the placebo effect, I use it just about routinely.
I can say that I see a better resolution rate in children than adults, but of course, this may or may not be associated with the medication. The use of it in conjunction with other “immunomodulators” sounds like a good idea, but I have not braved those waters yet. See: Pediatr Dermatol. 2001 Jul-Aug;18(4):349-52.Has anyone else tried this?
Tip Sullivan, DPM, Jackson, MS, tsdefeet@MSfootcenter.net
01/12/2012
RESPONSES/COMMENTS (CLINICAL )
RE: Multiple Verrucae in 4 Year Old Child (David Kahan, DPM)
From: Barry Mullen, DPM
Perfect indication! Cimetidine dose is 25 mg/kg/day in divided doses. Elixir available as 300 mg/tsp. Therapy duration varies between 3-12 weeks and is often dependent upon pre-therapy condition duration.
Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com
01/11/2012
RESPONSES/COMMENTS (CLINICAL ) - PART 1
From: Peter J Bregman, DPM
The recommended dosage for cimetidine for the treatment of warts is not exact, but the usual dose is around 30mgs/kg. It is very safe. You have to warn parents about headaches as the biggest side-effect, which may be hard to decipher in a 4 year old. You may want to just continue with using a topical as most warts in young kids resolve spontaneously anyway. I am not sure there is any benefit at all by using duct tape except for its ability to occlude.
10/31/2011
RESPONSES/COMMENTS (CLINICAL ) - PART 2
RE: Excellent Article on MRI Over-Usage in Sports Medicine
From: Rich Rettig, DPM
Here is an excellent article that I recommend from the New York Times regarding overuse of MRIs in sports medicine. There are a lot of references to the foot and ankle.
Rich Rettig, DPM, Philadelphia, PA, rettigdpm@gmail.com
10/31/2011
RESPONSES/COMMENTS (CLINICAL ) - PART !
RE: ACell (Saera Arain-Saleem, DPM)
From: Jefferson J. Mennuti, DPM
There is no indication to use Acell for a bunionectomy. There are forums that discuss using Acell powder during hair transplants, as there is little to no scarring with its use. Is there a purpose for using Acell matristem for a bunionectomy? If your patient is interested in a cosmetic scar, then she would have to pay cash. As far as I know, insurance will not cover Acell application for bunionectomy incisions. If she is willing to pay cash, I see no reason why it cannot be used. You sprinkle some powder over the incision site prior to dressing it.
Let’s face facts: regenerative medicine is...
Editor's note: Dr. Mennuti's extended-length letter can be read here.
09/05/2011
RESPONSES/COMMENTS (CLINICAL )
RE: Study Provides First Evidence-Based Colchicine Dosing Recommendations
From: Chris Albritton, DPM
Every practicing podiatrist in America needs to be aware of this new information.
"Colchicine, a widely used drug for the prevention and treatment of gout flares, interacts dangerously with many commonly prescribed pharmaceuticals such as antibiotics, antihypertensive drugs, antifungals, immunosuppressants, and protease inhibitors, according to a study published in the August issue of Arthritis & Rheumatism. However, most patients can take colchicines safely with these medications as long as the dose is adjusted, the study indicated.
To develop evidence-based colchicine-dosing algorithms with improved safety, a series of drug-drug interaction (DDI) studies was performed to assess the... "
Editor's Note: The study referenced in Dr. Albritton's extended-length letter can be read here.
08/22/2011
RESPONSES/COMMENTS (CLINICAL )
RE: Epidermolysis Bullosa (Dean Clement, DPM) From: Michael Bednarz, DPM
I recommend that Dr. Clement contact the Molnlycke Health Care rep in his area. They offer a wide range of products specifically designed to treat this condition. The main factor in treating these children is removing any type of shear force to the skin.
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