Absence of human papillomavirus DNA in the plume of erbium:YAG laser-treated warts

Bnckground: The erbium:YAG laser (Continuum Biomedical, Dublin, Calif.) is a new resurfacing and ablating laser that produces minimal residual thermal damage. Laser safety requires careful attention to the hazards of the laser plume. It is important to know whether viable organisms survive in the vapors. Human papillomavirus (HPV) DNA has been detected in the vapor of carbon dioxide laser-treated and electrodesiccated human warts. The presence or absence of HPV DNA in the laser plume of erbium:YAG laser-treated warts has not been previously studied to out knowledge, Objective: Our purpose was to determine the presence or absence of HPV DNA in the laser plume of erbium:YAG laser-treated human warts. Methods: One half of clinically typical and histopathologically confirmed verrucae vulgares from five patients were submitted for HPV DNA detection with in situ hybridization. After erbium:YAG laser ablation of the remainder of the warts, the laser plume was deposited on the handpiece as an abundant fluffy material and was submitted for evaluation of HPV DNA by polymerase chain reaction with consensus primers for the HPV type detected in the wart specimens. Results: HPV2 DNA was found in all warts. HPV DNA was not detected in the erbium:YAG laser plume after ablation of these same warts. Conclusion: The absence of HPV DNA in the plume of erbium:YAG laser-treated warts is a significant safety feature of this laser.