Diphencyprone in the Management of Refractory Palmoplantar and Periungual Warts: An Open Study

Abstract

Background: Induction of delayed-type hypersensitivity has recently been introduced for resistant viral warts. The method is not painful and less destructive than most other modalities. Objective: We assessed the efficacy of topical diphencyprone (diphenylcyclopropenone) treatment for recalcitrant warts. Methods: From September 1988 to June 1995, 134 patients with periungual and/or palmoplantar warts were entered into the study. Eight weekly applications were delivered. Results: The scheduled treatment course and follow-up were completed by Ill patients. There were 49 complete and 18 partial remissions. The rate of positive responders (60%) compares with the results published by other authors. Conclusion: Diphencyprone is an effective treatment for resistant warts, especially in palmoplantar and periungual locations.

Topical Immunotherapy with Diphenylcyclopropenone Is Effective and Preferred in the Treatment of Periungual Warts

“…Our cure rate of 85% (by subject) is comparable to that of other treatment modalities for periungual warts reported in the literature: 60% for DPCPi9, 90% for cryotherapy13, and 51.1% for pulsed-dye laser18. It was even higher (91%) when evaluated by the individual lesions.…”

“…DPCP was first reported to successfully treat patients with resistant plantar warts in 198415 and since then, there have been several other reports of recalcitrant warts, including periungual warts, which were successfully treated with DPCPi8-10,16,17. It has been reported to have a high response rate, absence of scarring and painless application8,9.…”

Treatment of palmoplantar warts with a diphencyprone and salicylic acid ointment

“…Failure to sensitize after two applications of DPCP in acetone occurs in 1-3% of patients in previously reported series. [7][8][9] In our patient group, the keratolytic properties of salicylic acid appeared to help by preventing thick keratotic buildup over the warts. This may have helped with absorption of the DPCP into the thick skin.…”

Treatment of common warts with surgery and systemic isotretinoin

“…Antimitotic therapy is achieved by podophyllin/podophyllotoxin, bleomycin, and retinoids [1,6,8,9,14,16]. Immune stimulation can be initiated with dinitrochlorobenzene, squarid acid dibutylester, diphencyprone and cimetidine [2,12,21,22,23,30].…”

“…There is no single treatment that is 100% effective, and different types of therapy may be combined. The appropriate treatment option depends on a variety of factors (including the age of the patient, location of the lesion, past treatment, etc) and includes a variety of acids, podophyllin, podophyllotoxin, chemotherapeutic agents, retinoids, topical sensitizers, a spectrum of surgical techniques, and cryotherapy [1,2,3,6,7,8,9,11,12,13,14,15,16,21,22,23,24,25,26,28,29,30].…”