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Emeritus Professors of Clinical Psychopharmacology should really be a
little more sanguine about their knowledge of dermatology before embarking
on treatises(1) on the subject of warts!.
The treatment of warts with liquid nitrogen is undertaken by spraying
it on the surface, NEVER by injection since its physical properties
render this quite impossible, occasionally warts are treated by injection
of Bleomycin (and similar noxious chemicals) and either technique can
occasionally produce unexpected and quite ‘exciting’ reactions in
susceptible individuals (eg those with disorders of coagulation) or if
administered over enthusiastically.
His concept that the recommended treatment for verrucas is to ‘leave
them alone’ is truly wondrous. Perhaps he would like to use all his
clinical psychopharmaceutical skills and experience to convince the myriad
of patients demanding treatment (and their parents) that this is the case.
If he could do so he would without doubt qualify for the position of
patron Saint of General Practitioners and Dermatologists (though perhaps
not of Chiropodists!)
Dr Angus Macdonald FRCP
Combe Manor Farm
Wadhurst
East Sussex TN5 6NU
The photograph on this page is a useful cautionary tale. However, it
lacks credibility on two points. One could take issue with the statement
that the recommended treatment for verrucas is to leave them alone, but
this is of minimal importance compared with the glaring error regarding
use of liquid nitrogen.
The author states that the patient had injections of liquid nitrogen
for a verruca. I doubt if it would be physically possible to achieve this
given the boiling point of -196 degrees. Liquid nitrogen is of course
administered externally by spray, probe or cotton bud.
Dr Neil H Cox, BSc(Hons), FRCP (Lond & Edin)
Consultant Dermatologist
Carlisle
CA2 7HY
Re: Minerva
Sir
Emeritus Professors of Clinical Psychopharmacology should really be a
little more sanguine about their knowledge of dermatology before embarking
on treatises(1) on the subject of warts!.
The treatment of warts with liquid nitrogen is undertaken by spraying
it on the surface, NEVER by injection since its physical properties
render this quite impossible, occasionally warts are treated by injection
of Bleomycin (and similar noxious chemicals) and either technique can
occasionally produce unexpected and quite ‘exciting’ reactions in
susceptible individuals (eg those with disorders of coagulation) or if
administered over enthusiastically.
His concept that the recommended treatment for verrucas is to ‘leave
them alone’ is truly wondrous. Perhaps he would like to use all his
clinical psychopharmaceutical skills and experience to convince the myriad
of patients demanding treatment (and their parents) that this is the case.
If he could do so he would without doubt qualify for the position of
patron Saint of General Practitioners and Dermatologists (though perhaps
not of Chiropodists!)
Dr Angus Macdonald FRCP
Combe Manor Farm
Wadhurst
East Sussex TN5 6NU
1 BMJ 318 p474 Minerva
Competing interests: No competing interests