TFP Thread

[heybrother]

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ok what's everyone's thoughts on needling for treatment for plantar warts? essentially you numb up the wart and stab it a ton of times with a needle and it works really well... supposedly. this is called faulkner's treatment or faulknor seen it spelled either way

The problem is that you presumably have to numb the wart to do this. There are studies out there where they needle in 5-FU / TCA etc while doing what you describe.

Here's my battle. The studies say TCA is fairly effective. My experience is less so. There was an Indian Dermatology Journal a few years ago that claimed a retinoid topical that is OTC in the states was 100% effective. I never saw a person resolve with it. So - my experience is that therapies appears to be less effective than the journals that write about them describe them to be. You can try any therapy you desire but your mileage may vary. People on here will claim they use x, y, z, and that its amazing but the level of success shared by people on here is often greater than what journals say and I already think the journals are lying.

 

[BeaverBlade]

The problem is that you presumably have to numb the wart to do this. There are studies out there where they needle in 5-FU / TCA etc while doing what you describe.

Here's my battle. The studies say TCA is fairly effective. My experience is less so. There was an Indian Dermatology Journal a few years ago that claimed a retinoid topical that is OTC in the states was 100% effective. I never saw a person resolve with it. So - my experience is that therapies appears to be less effective than the journals that write about them describe them to be. You can try any therapy you desire but your mileage may vary. People on here will claim they use x, y, z, and that its amazing but the level of success shared by people on here is often greater than what journals say and I already think the journals are lying.

I feel like i've seen more plantar warts in my young career than maybe any podiatrist. idk why. it's so common where i practice. i do see a ton of peds.

my conclusion is every person responds differently. i've tried everything.

i've had aldara cream not do anything for people then i had some people where it was cured overnight
same with 5-fu. i use this compounded with saliclyic acid as my go to.
tca has never done anything for me. i legit think the studies are lying.
catharone just destroys everything. so therefore it is effective.
silver nitrate i do in office because i find it easy to buy/use.
cyrotherapy i just don't like. never felt comfortable deciding how long to hold it on exactly and honestly didn't find it that effective.

If there was a great cure for these the world would know probably. i do get patients who get mad it's not cured immediately though. might start cutting out more in office but i need lido with epi. maybe the scar thing is overblown? who knows. feel like a patient would hate me if they develop a painful plantar scar though. i've cut out a lot and never had that develop but meh patients do get annoyed with a hole in their foot wish I could find a better quick cure than surgical excision

 

[Flip-flop-flerpity]

I recently tried this. 8 weeks later and nothing. Can we please just get access to canthardin and make podiatry great again??

 

[DYK343]

ok what's everyone's thoughts on needling for treatment for plantar warts? essentially you numb up the wart and stab it a ton of times with a needle and it works really well... supposedly. this is called faulkner's treatment or faulknor seen it spelled either way

Several years ago (like 5+) I had a younger patient with ~20+ warts on each foot.

I did reverse innoculation - Numb up a single (juicy looking) wart. Use a 2mm punch biopsy. Pull the biopsy plug out. Reverse it so epithelial side is now embeded deep in fat. Steristrip over top.

Robust pain response. Patients parents were calling reporting severe pain. But within a month every wart was gone.

Havent done it again since but it was my only option at the time and it worked.

Most TFP thing ive ever done.

Fluorouracil is my goto for warts. Works incredibly well. No pain. But not sure it would work when both feet are near 100% wart.

 

[Feli]

Make sure to know your new plantar fasciitis codes starting tomorrow, TFPs...

M67.A01: Plantar fasciitis, right foot
M67.A02: Plantar fasciitis, left foot

 

[Feli]

...younger patient with ~20+ warts on each foot. ...

Cimetidine is worth a try on those... no pain/crying.

 

[Adam Smasher]

Make sure to know your new plantar fasciitis codes starting tomorrow, TFPs...

M67.A01: Plantar fasciitis, right foot
M67.A02: Plantar fasciitis, left foot

NEW PLANTAR FASCIITIS CODES JUST DROPPED

 

[BeaverBlade]

did anything else change or just that code?

 

[heybrother]

did anything else change or just that code?

Plantar fasciitis and plantar fibromatosis now have separate codes.