Successful treatment of plantar warts with intralesional bleomycin and electroporation: pilot prospective study

Abstract

BackgroundNumerous studies have been performed to evaluate the efficacy of intralesional bleomycin for the treatment of warts with inconsistent result. Nevertheless, it is well known that the cytotoxicity of bleomycin can be enhanced in vivo by 300 to 700-fold by electroporation.Objective and MethodsIn this article, we present an interventional, one-center, prospective case series, clinical trial of the effectiveness of intralesional bleomycin combined with electroporation for the treatment of plantar warts, in comparison to the use of intralesional bleomycin alone.ResultsThe study’s cohort included 12 men and 10 women, with a mean age of 53.8 years. A total of 22 warts were treated. In dividing the patients in two groups (complete remission against all the others) and analyzing the different outcomes in the two arms of patients, a statistical significant difference was found (p=0.0015), proving a greater efficacy of the treatment with bleomycin combined with ECT as opposed to bleomycin alone. Electroporation was always well tolerated by the patients with no discomfort.ConclusionsThis study serves as a basis for the application of novel protocols in the treatment of different benign and locally malignant skin lesion by means of electroporation.

Ungual warts: comparison of treatment with intralesional bleomycin and electroporation in terms of efficacy and safety

“…The cure rate was superior in the group for which electrochemotherapy associated with intralesional use of bleomycin was performed (78% vs. 16%), and this difference was statistically significant. Similar to the data found in our study, no systemic side‐effects were observed, with only erythema and oedema being reported as local side‐effects …”

“…Similar to the data found in our study, no systemic side-effects were observed, with only erythema and oedema being reported as local side-effects. 46 We observed that the side-effects were more frequently observed in the electrochemotherapy group (pain, haemorrhagic necrosis, onycholysis, infectious process and reflex sympathetic dystrophy). Although more frequent and intense, the side-effects in the electrochemotherapy group were tolerable for patients, there were no long-term sequelae, and no systemic adverse effects were observed.…”

“…A recent study compared the intralesional use of bleomycin with the intralesional use associated with electroporation for the treatment of 22 plantar wart patients with a single application and a 3‐month follow‐up . As with our study, a biopsy of all the lesions was also performed prior to the onset of treatment, and in all cases, the lesions had been left untreated for at least 6 months.…”

“…22 A recent study compared the intralesional use of bleomycin with the intralesional use associated with electroporation for the treatment of 22 plantar wart patients with a single application and a 3-month follow-up. 46 As with our study, a biopsy of all the lesions was also performed prior to the onset of treatment, and in all cases, the lesions had been left untreated for at least 6 months. The cure rate was superior in the group for which electrochemotherapy associated with intralesional use of bleomycin was performed (78% vs. 16%), and this difference was statistically significant.…”

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

“…There is no concensus about the procedure for application, the frequency of application, concentration, and dosing schedule ending up with bleomycin being level 1 strength of evidence in treating warts. 11 In the current study, we used intralesional bleomycin with single and multiple puncture techniques induced by microneedling. Among the first to use the multipuncture technique for different types of warts.…”