Intralesional bleomycin injection vs microneedling-assisted topical bleomycin spraying in treatment of plantar warts

J Cosmet Dermatol. 2019 Feb;18(1):124-128. doi: 10.1111/jocd.12537. Epub 2018 Apr 23.

Abstract

Background: Warts, or verrucae, are benign epithelial profilerations of skin and mucosa caused by infection with HPV and poses a challenge to treat.

Objective: To compare between single and microneedling-assisted multipuncture techniques of intralesional application in treatment of plantar warts.

Methods: The study included 60 Patients who were divided into two groups (A&B). Each group consisted of (30) patients. Group (A) subjects received intralesional bleomycin with a single injection using syringe needle. For Group (B) subjects, we combined microneedling with topical spraying of bleomycin (MN + Bleo) and followed by occlusion for 2 hours.

Results: The results revealed complete clearance of warts in 21 patients in group (A) (70%) whom were treated by intralesional (IL) bleomycin vs 25 patients (83.3%) in group (B) whom were treated by spraying of bleomycin following microneedling. Side effects other than pain, erythema, and transient induration were relatively infrequent, and no nail changes or Raynaud's phenomenon was observed in both groups.

Conclusion: We established a good safety and efficacy profile for bleomycin in plantar wart treatment and we demonstrated that microneedling followed by bleomycin spraying had a higher clearance and proved less painful as opposed to bleomycin injection.

Keywords: Bleomycin; microneedling; warts.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Antibiotics, Antineoplastic / administration & dosage*
  • Antibiotics, Antineoplastic / adverse effects
  • Bleomycin / administration & dosage*
  • Bleomycin / adverse effects
  • Female
  • Foot Dermatoses / drug therapy*
  • Humans
  • Injections, Intralesional / adverse effects
  • Male
  • Needles / adverse effects
  • Warts / drug therapy*
  • Young Adult

Substances

  • Antibiotics, Antineoplastic
  • Bleomycin