Intralesional cryotherapy versus combined cryotherapy with either intralesional candidal antigen or bleomycin in resistant plantar warts: A comparative study .

Abstract

Introduction: Plantar warts represent a frequent condition in clinical dermatological practice. Human papillomavirus (HPV) type 1 is responsible for the majority of cases. Most therapies act to eliminate the affected epidermal cells by cell destruction but this may not always be effective in eradicating the latent virus in surrounding cells. Accordingly, treatments may fail, resulting in recalcitrant warts. It was proved that combined treatment including intralesional therapy, is more efficient than single treatment for plantar warts. Cryotherapy involves freezing affected tissue with liquid nitrogen and then slowly thawing it. Intralesional injection of Candida antigen improves the immune system's identification of the virus via delayed-type hypersensitivity, helping to eliminate HPV infection not only the targeted wart but also warts at distant locations. Bleomycin injection possesses antitumor, antibacterial, and antiviral properties that may be linked to its capacity to bind to DNA and destroy infected cells.Aim: To assess the efficacy of intralesional cryotherapy compared to its combination with Candidal antigen injection and compared to its combination with intralesional injection of bleomycin in treating resistant plantar warts.