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Recalcitrant plantar warts are representing a therapeutic challenge. Intralesional cryotherapy (ILC) has emerged as a promising therapeutic option in recalcitrant plantar warts treatment. To compare the clinical efficacy, safety and tolerability of (ILC) versus Cryotherapy spray (Cryo-sp) for treatment of recalcitrant plantar warts. One hundred-thirty patients with recalcitrant plantar warts were assigned equally to two groups. Group A received ILC and group B treated with Cryo-SP. Both groups received one session at 2 weeks intervals until complete clearance or for a maximum of 5 sessions. The main outcome was complete clearance of warts guided by dermoscopy. Follow-up was carried out for 6 months after the treatment. Complete clearance occurred in 80.3% in group A compared to 50.8% in group B with a highly significant difference between both groups ( p  &lt; .001). The clearance rate was faster in group A (1.5 ± 0.40) than group B (4 ± 1.3) ( p  &lt; .001). The adverse effects were mild in group A than group B ( p  &lt; .001). The recurrence rate was 2% in group A versus 23.3% in group B ( p  &lt; .007).patients satisfaction was higher in ILC ( p  &lt; .001). Intralesional cryotherapy is more effective, requiring few sessions with a low recurrence rate than cryo-sp.

Intralesional cryotherapy versus cryotherapy spray for the treatment of recalcitrant plantar warts: a prospective, randomized study