Extragenital warts in immunocompetent people are harmless and usually resolve spontaneously as a result of natural immunity within months or years. The rate of resolution is highly variable and probably depends on a number of factors, including host immunity, age, HPV type and site of infection. One frequently cited study of an institutionalised population showed that two-thirds of warts resolved within a 2-year period.7 Evaluation of control group clearance rates within randomised controlled trials (RCTs) may also give some indication of natural clearance rates, although a non-specific benefit of vehicle bases may make interpretation difficult. Seventeen of the RCTs discussed in more depth later in this chapter included a placebo group and used participants rather than warts as the unit of analysis. The average cure rate with placebo preparations in these trials was 30% (range 0-73%) after an average period of 10 weeks (range 4-24 weeks).
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