Treatment of viral warts by intralesional bleomycin

The efficacy and tolerability of intralesional bleomycin (B) for the treatment of viral warts (VW) were evaluated. Eighty-two patients affected by periungueal, palmar or plantar VW unresponsive to common therapies (keratolytic agents, criotherapy, electroessication), were studied. After percutaneous anaesthesia, 1 U/ml of B solution was placed on the VW and pricked into them by using a prick test needle. The treatment was repeated every 2 or 3 weeks until the VW cleared, or was stopped if the lesion was still present after 6 treatments. Healing was obtained in 89% of patients. The best result was obtained in patients affected by periungueal VW (96.8% of healing). The number of treatments was lower for smaller VW. Mild local pain was the only side-effect reported by almost all the patients. In conclusion, injection of B into intractable VW by the pricking technique seems to be an effective and well tolerated therapy, expecially for periungueal VW.