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

Abstract

BackgroundThere exists a treatment challenge with periungual warts. Topical immunotherapy with diphenylcyclopropenone (DPCP) has recently been reported to be an effective treatment for recalcitrant warts, including periungual types.ObjectiveWe aimed to evaluate the effectiveness and preference of topical immunotherapy with DPCP in treating periungual warts.MethodsTwenty-seven patients with periungual warts who were treated with DPCP immunotherapy (2007 through 2010; Dongguk University Ilsan Hospital, Goyang, Korea) were retrospectively recruited. Other treatment modalities were also used in some patients. Lesions were grouped into the types according to the following locations: proximal nail fold, lateral nail fold and hyponychium. Total and group clearance rates as well as treatment periods according to location and disease duration were evaluated. A patient questionnaire was performed to assess the satisfaction for the treatments in those who received multiple therapies.ResultsTotal success rates were 85% (by subjects) and 91% (by individual lesions). Success rate and treatment period for proximal nail fold type seemed more desirable than other locations. Success rate decreased and treatment period increased as disease duration increased. The questionnaire revealed a significantly higher satisfaction rate for DPCP immunotherapy than for cryotherapy and pulsed-dye laser.ConclusionTopical immunotherapy with DPCP is an effective and preferred method in the treatment of periungual warts.

Factors contributing to the treatment duration of diphenylcyclopropenone immunotherapy for periungual warts

“…Periungual warts have proven to be difficult to treat, and recurrences are common . In particular, destructive modalities such as cryotherapy and CO 2 laser ablation are limited when used near periungual regions because they can result in nail deformities . Recent studies have shown that topical immunotherapy with DPCP is a safe and effective treatment for recalcitrant warts, including periungual types.…”

“…In that report, the cure rate was 85% for 27 subjects, which is comparable to other reported treatment modalities for periungual warts: 90% for cryotherapy and 51% for pulsed‐dye laser. Cryotherapy has been reported to have a high cure rate, but its side effects include pain, infection, and nail deformities especially with periungual warts . Immunotherapy has many advantages compared with cryotherapy, including lower complication and recurrence rates and smaller sizes of relapsing warts, as well as the ability to treat multiple lesions simultaneously.…”

Judicial precedents associated with periungual warts in South Korea

“…Periungual wart is a common recalcitrant infectious disease that is challenging to treat . Nail matrix involvement of periungual wart is common, and treatment can cause permanent damage to the nail matrix .…”

Advancements in Pharmacotherapy for Noncancerous Manifestations of HPV

“…This process is repeated every week until the warts clear [61]. There have been other studies that utilize a sensitization of 2% DPCP instead of a concentration of 0.1%.…”