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J Cutan Aesthet Surg. 2011 Sep;4(3):188-91. doi: 10.4103/0974-2077.91250.

Efficacy of Intralesional Bleomycin in Palmo-plantar and Periungual Warts.

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1
Departments of Dermatology, Venereology and Leprosy, SP Medical College, Bikaner, Rajasthan, India.

Abstract

BACKGROUND/AIM:

Intralesional bleomycin gained increasing popularity in the recent past for treatment of warts particularly in palmo-plantar and periungual regions as other modalities are not very effective. Hence we evaluated the role of intralesional bleomycin in periungual and palmo-plantar warts to know its efficacy in Indian patients.

SETTINGS AND DESIGN:

This was a placebo-controlled study.

MATERIALS AND METHODS:

Fifty patients of multiple palmo-plantar and periungual warts were included in this study and categorized in groups A and B of 25 each. Alternate patients were included in groups A and B and treated respectively with intralesional bleomycin (1 mg/mL solution) and normal saline as placebo, fortnightly for maximum up to two injections. Patients were followed up weekly for 1 month, fortnightly up to 12 weeks, and then quarterly for 1 year. If warts persisted after 12 weeks of starting treatment, it was considered a failure. Statistical analysis was done by the chi-square test using M-stat software.

RESULTS:

Group A and B patients were having 85 warts and 72 warts, respectively. The cure rate in group A and B patients was 96.47% (82/85 warts) and 11.11% (8/72 warts), respectively, after one or two injections within 12 weeks. The difference in the cure rate between two groups was statistically highly significant (<0.0001). In group A patients, a haemorrhagic eschar was formed which gradually healed in 8-12 weeks without atrophy or pigmentation; this phenomenon was not seen in group B. Only moderate pain was observed by most of the patients during injection in both groups.

CONCLUSION:

The intralesional injection of bleomycin is highly effective, safe, and non-toxic in periungual and palmo-plantar warts.

KEYWORDS:

Bleomycin; intralesional injection; palmo-plantar and periungual warts

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