Efficacy of Intralesional Bleomycin in the Treatment of Resistant Warts

Warts are benign tumors of the skin and mucosa and are caused by human papilloma virus (HPV). They are one of the most common skin diseases found mainly in children and adolescents. Although most of the warts disappear spontaneously or respond to the usual therapeutic measures, resistant forms of the warts impose a problem in dermatology. Intralesional injection of bleomycin has been tried in the treatment of resistant warts with variable results in different studies. This study aimed to assess the efficacy of intralesional injection of bleomycin in resistant warts. In this cross-sectional study, a total of 130 warts in 30 patients were treated with 1 mg/mL intralesional injection of bleomycin. Patients received one to three doses of bleomycin every four weeks, and were followed for six months. Response to the treatment was categorized as complete resolution, partial resolution, and nonresponsive. We employed SPSS version 13 to perform t test and analysis of variance (Anova) as statistical methods for analyzing the data. Out of 130 warts, 126 (97%) cases showed resolution after bleomycin injections. Ninety-five warts (73%) showed complete resolution and 31 (24%) cases showed incomplete resolution. The cure rate (80%) was better in warts with the size smaller than 20 mm in diameter in comparison with larger lesions (46%). After six months follow-up, 7 patients showed recurrence. Recurrence was seen more among those with greater number of warts. This form of treatment for resistant warts would be reliable, safe, and acceptable to the patients if it is performed under care and with proper dose and concentration.