A study on the efficacy of intralesional bleomycin for the treatment of periungual and palmoplantar warts


  • Neerja Puri Department of Dermatology, Punjab Health Systems Corporation, Punjab, India




Bleomycin, Palmoplantar, Periungual, Warts, Modalities, Intralesional


Background: Amongst the different modalities for the treatment of warts, not a single modality is fully effective. While treating warts, the possibility of spontaneous regression must also be kept in mind. The aim of treating warts is to induce long term immunity without recurrences. To study the efficacy and safety of intralesional bleomycin for the treatment of twenty patients with periungual and palmoplantar warts.

Methods: We conducted a prospective study of twenty patients of resistant periungual and palmoplantar warts between the age group of 15-50 years. Three injections of bleomycin were given at an interval of 2 weeks for a maximum of 3 injections (or less if the resolution occurred earlier).

Results: After three sessions, complete clearance of palmoplantar warts was 71.42% and that of periungual warts was 90.90%. lesions were seen in 82% patients and incomplete resolution was seen in 15% patients. Bleomycin has antibacterial, antiviral and cytotoxic activity. Commonest side effect after bleomycin injection was pain seen in 40% (8) patients followed by pigmentary change and Raynauds phenomenon seen in 5% (1) patient each.

Conclusions: Bleomycin is an effective and promising treatment of recalcitrant warts especially in palmoplantar and periungual.


Author Biography

Neerja Puri, Department of Dermatology, Punjab Health Systems Corporation, Punjab, India



Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006;4:273-93.

Berthe JJ, Bourke J, Egilitis H, Harper C, Kirk P, Pavord S, et al. Value of second freeze thaw cycle in cryotherapy of common warts. Br J Dermatol. 1994;131:883-6.

Sterling JC, Handfield JS, Hudson PM. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001;144:4-11.

Lewis TG, Nydorf ED. Intralesional bleomycin for wart: A review. J Drugs Dermatol. 2006;5:499-504.

Vanhooteghem O, Richert B, Brassinne M. Raynaud phenomenon after treatment of verruca vulgaris of the sole with intralesional injection of bleomycin. Pediatr Dermatol. 2001;18:249-51.

Toledo CH, Ross WE, Hood CI, Block ER. Potentiation of bleomycin toxicity by oxygen. Cancer Treat Rep. 1982;66:359-62.

Hayes ME, Keefe OEJ. Reduced dose of bleomycin in the treatment of recalcitrant wart. J Am Acad Dermatol. 1986;15:1002-6.

Cordero AA, Guglielmi HA, Woscoff A. The common wart. Intralesional treatment with Bleomycin sulfate. Cutis. 1980;26:319-24.

Bremner RM. Warts: Treatment with intralesional bleomycin. Cutis. 1976;18:264-6.

Salk R, Douglas TS. Intra lesional bleomycin sulfate injection for the treatment of verruca plantaris. J Am Podiatr Med Assoc. 2006;96:220-5.

Shumer SM, Keefe OEJ. Bleomycin in the treatment of recalcitrant warts. J Am Acad Dermatol. 1983;9:91-6.

Olson RL. Plantar warts yield to DNA inhibitor. JAMA. 1977;237:940-4.

Shelley WB, Shelley ED. Intralesional bleomycin sulfate therapy for warts: A novel bifurcated needle puncture technique. Arch Dermatol. 1991;127:234-6.

Mizuno S. Ishida A. Selective enhancement of bleomycin cytotoxicity by local anaesthesia. Biochem Biophys Res Commun.. 1982;105:425-31.






Original Research Articles