Topical cidofovir for plantar warts

Abstract

Plantar warts are a common reason for dermatological consultations and their treatment can occasionally be a challenge. Plantar warts are benign lesions produced by the human papillomavirus (HPV) that often fail to respond to habitual treatment. Cidofovir is a potent antiviral drug that acts competitively, inhibiting viral DNA polymerase. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral plantar warts. We undertook a retrospective observational study of patients with plantar warts who received treatment with topical cidofovir between July 2008 and July 2011 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data about the rate of treatment response, the adverse effects, and recurrences, as well as the characteristics of the patient cohort, were recorded. We identified 35 patients who had received some previous treatment. The usual concentration was 3% (in 33 of 35 cases), applied twice a day (in 31 of 35 cases). A greater or lesser response was noted in 28 cases. There were two recurrences. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant plantar common warts that fail to respond to usual treatment.

Recalcitrant warts and topical cidofovir: predictive factors of good response

“…Topical cidofovir could be considered a useful therapeutic option for the management of warts that are recalcitrant to usual therapies. 5,6 We can recommend, regarding at our results, cidofovir 3% cream twice daily with occlusion for a period of about 12 weeks at least to check if there is response or not; specially in female patients and those younger than 15 years. 7 If within this time there is no reduction in the size or number of PW it might be advisable to suspend the treatment due to lack of efficacy.…”

Advancements in Pharmacotherapy for Noncancerous Manifestations of HPV

“…Although cidofovir is only FDA approved for CMV retinitis in human immunodeficiency virus (HIV) patients, there are many reports of successful topical and intralesional use for HPV lesions [13,14]. Intravenous cidofovir is avoided as it is associated with nephrotoxicity, ocular injury (anterior uveitis, retinal detachment, iritis and permanent loss of vision), and possible teratogenicity [15].…”

“…Treatment should be stopped if there is no response after 10 weeks [14]. The most common side effects of topical cidofovir are pain, pruritus and rash at the application site.…”

Successful treatment of plantar warts using topical Zijinding, a traditional Chinese medicine preparation: A case series

“…Treatment is aimed at relieving the patient's physical and psychological discomfort and at preventing the spread of infection by autoinoculation. Among the available medical and physical ablative therapeutic options for plantar warts, including salicylic acid, and cryotherapy, none are uniformly effective or virucidal . Salicylic acid is the first‐line therapy but approximately one‐third of lesions do not resolve and become recalcitrant despite repeated treatment which cause the patients psychological distress .…”