Radiosurgical removal of a skin lesion - warty nevus

Radiocauterization of skin lesions is a minimally invasive dermatological procedure that uses radiofrequency energy for the precise and controlled removal of superficial skin lesions.

Common warts (verruca vulgaris) are benign skin lesions caused by infection with the Human Papillomavirus (HPV). They commonly occur on the hands, fingers, elbows, or soles of the feet and may spread through direct contact or minor skin trauma.

Clinically, warts appear as hyperkeratotic lesions with an irregular surface, often raised, and gray, brown, or skin-colored. They may be solitary or multiple and are often cosmetically bothersome, painful on pressure, or prone to repeated trauma, particularly when located in areas exposed to friction, such as the palms, soles, or fingers.

Radiocauterization is an effective treatment method that consists of targeted destruction of the lesion using a fine radiofrequency electrode under local anesthesia. The procedure is quick, well tolerated, and enables complete removal of the wart with a minimal risk of recurrence.

Assessment Before the Procedure

• Type of wart (common, plantar, filiform, etc.)
• Size and depth of the lesion
• Anatomical location (pressure-bearing or friction areas)
• Number of lesions present
• Degree of hyperkeratosis or local inflammation
• Patient preferences and history of recurrence or previous treatments

Purpose of the Procedure

• Removal of clinically confirmed benign verrucous lesions
• Prevention of lesion spread and viral autoinoculation
• Reduction of local discomfort (pain, bleeding, irritation)
• Improvement of the skin's aesthetic appearance
• Prevention of secondary infection or chronic lesion development

Indications

• Clinically and dermoscopically confirmed warts
• Painful, traumatized, or bleeding lesions
• Cosmetic or functional discomfort
• Poor response to topical treatments
• Rapid spread of lesions

Relative Contraindications

• Active infection in the treatment area
• Allergy to local anesthetics
• Unidentified pigmented or hemorrhagic lesions
• Pregnancy (for genital lesions)

Procedure

• The treatment area is cleansed and disinfected
• Local anesthesia (topical or injectable, if necessary) is administered
• The lesion is ablated using a radiofrequency electrode
• The lesion base is coagulated when required
• A sterile dressing is applied, and post-procedure care instructions are provided

Procedure duration: approximately 5–15 minutes, depending on the size and number of lesions.

Complete healing usually occurs within 7–10 days, with the formation of a crust that falls off naturally.

Benefits

• Fast, precise, and safe procedure
• Minimal discomfort and short recovery time
• Suitable for various body areas
• Low recurrence rate when post-procedure care recommendations are followed
• Multiple lesions can be treated during a single session

Post-Procedure Recommendations

• Avoid wetting the treated area for 24–48 hours
• Do not remove the crust; allow it to detach naturally
• Apply a local antiseptic as prescribed
• Avoid hot baths, swimming pools, excessive friction, and pressure on the treated area during healing
   

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8423214/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4835659/
https://www.joms.org/article/S0278-2391(13)01327-X/fulltext
https://www.bad.org.uk/pils/skin-cancer-how-to-reduce-the-risk-of-developing-skin-cancer/
https://www.researchgate.net/publication/287108582_Treatment_of_Verrucous_Epidermal_Nevus_by_Radiofrequency_Ablation_A_Case_Report
https://www.aafp.org/pubs/afp/issues/2015/1001/p601.html