The treatment of resistant warts with intralesional bleomycin: a controlled clinical trial

Abstract

A controlled double-blind trial was carried out on fifty-nine matched pairs of hand warts in a group of twenty-four patients, with proven resistance to treatment, to study the effectiveness of the intralesional injection of 0.1% solution of bleomycin sulphate in normal saline, compared with a normal saline placebo injected into the paired warts in the same patient. We found that 87.5% of patients showed a more favourable response to bleomycin (P less than 0.001); 76% of the fifty-nine warts treated with bleomycin were cured by one to three injections of up to 0.2 ml of solution. Subsequently 75% of thirty-two patients with resistant hand warts and 66% of fifteen patients with mosaic plantar warts were cured of all their warts. No patient received more than 4 mg of bleomycin. No toxicity was experienced. Local pain was on the whole well tolerated. This form of treatment for resistant warts is reliable, safe and acceptable to patients.

Successful Treatment of Plantar Warts with Very Diluted Bleomycin Using a Translesional Multipuncture Technique: Pilot Prospective Study

“…30 Therapeutic concentrations of 1, 0.5, and 0.25 U/mL have been previously used for different types of warts." Several reports have documented untoward effects such as hyperpigmentation, localized pain, and cellulltis.i"…”

Intralesional bleomycin in the treatment of cutaneous warts: A randomized clinical trial comparing it with cryotherapy

“…Their cure rate was 89.9%. Bunney et al, [22] carried out a study on 59 matched pairs of hand warts in 24 patients with intralesional bleomycin, compared with a normal saline placebo injected into the paired warts in the same patient found a cure rate of 76%. In Munn et al study, [31] bleomycin solution was dropped on to the wart and then "pricked" into [32] in a study also mentioned a success rate of 92%.…”

“…[7,8,[15][16][17][18][19][20][21][22][23][24][25][26][27][28] Numerous reports have been published on the use of intralesional bleomycin for the treatment of warts, with cure rates ranging from 14% to 99%. [15] In Bangladesh, still there is no study that has been conducted with intralesional bleomycin for the treatment of warts.…”

British Association of Dermatologists' guidelines for the management of cutaneous warts 2014

“…104 A smaller study, in which 24 patients with multiple warts had one wart treated with bleomycin and a similar wart injected with saline (control), reported a comparable clearance, with 58% of bleomycin-treated warts clearing compared with only 11% of the control warts. 105 When compared with cryotherapy, and using one body side for each treatment, bleomycin produced higher clearance rates (92-97% of bleomycin-treated warts vs. 76-82% of warts treated with cryotherapy). 106,107 The major side-effect of bleomycin is pain at the time of injection and for up to 48 h afterwards.…”