Intralesional bleomycin in palmoplantar and periungual warts: a therapeutic study
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20211387Keywords:
Bleomycin, Palmo-plantarwarts, Periungual wartsAbstract
Background: Warts are one of the most common benign growths of skin caused by human papilloma virus. No single treatment has proved to be completely effective and most therapies for palmo-plantar and periungual warts remain unsatisfactory. The present study was conducted to evaluate the therapeutic efficacy and safety of intralesional bleomycin injection in palmo-plantar and periungual warts in patients in region of south east India.
Methods: Ninety patients of multiple palmo-plantar and periungual warts were included in the study. They were infiltrated with bleomycin (1 mg/ml) till blanching. The treatment was repeated after paring of eschar at 2 weeks interval in cases with partial or no response. The patients were reviewed at monthly interval for 24 weeks to note cure, adverse effects, recurrence and outcome satisfaction levels.
Results: Out of total 305 warts, 103 (34%) were cured after 1st injection and 249 (82%) were cured after 2nd injection. The number of warts requiring more than 2 sittings was 55 (18%). At the end of study, overall cure rate was 94.5% and 10 patients showed recurrence.
Conclusions: Intralesional bleomycin injection is an effective and safe treatment option in palmo-plantar and periungual warts.
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