Intralesional cidofovir for the treatment of recalcitrant periungual warts

Cutaneous Applications of the Antiviral Drug Cidofovir: A Review

“…If multiple injections are required, local anesthesia may be administered to mitigate local pain associated with the IL injection [6]. Studies investigating the use of IL cidofovir for the treatment of all virally induced pathologies have reported diluting cidofovir 75 mg/mL with normal saline to produce concentrations ranging from 2.5 mg/mL to 37.5 mg/mL, with most studies using 15 mg/mL [14][15][16]. IL cidofovir should be injected directly into the lesion using serial puncture or crosshatching techniques [17].…”

“…Several local, self-limiting reactions have been reported regarding intralesional applications, including pain, burning, blistering, discoloration, swelling, and erosion when treating cutaneous warts [15]. Fewer, but similar, localized side effects have been described in non-verrucous applications, including inflammation and ulceration before progressive regression and disappearance [23,24].…”

“…Two of the patients with partial or complete clearance experienced recurrence at the ~9-month follow-up [36]. In another retrospective study of nine patients with recalcitrant periungual warts, IL cidofovir (25 mg/mL) was used and, following an average of 2.7 treatments, all patients experienced improvements in appearance, and seven patients saw the near resolution of the lesions [15]. For three patients, a 95% improvement in lesional appearance was seen after the first IL treatment [15].…”