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Intralesional bleomycin in palmoplantar and periungual warts: a therapeutic study

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.