How Effective Is Bleomycin for Warts?

Warts are benign epidermis caused by human papilloma virus (HPV). Clinically common warts are common, plantar warts, flat warts, and genital warts.

Basic Information

English name: verrucavulgaris
Visiting department: dermatology

Common causes: Papilloma virus (HPV)
Contagious: Have
way for spreading: Direct contact

Causes of common warts

Warts are caused by human papilloma virus (HPV) infection and can be transmitted through direct or indirect contact. Trauma or skin damage is also an important factor for HPV infection. The course of warts has an important relationship with the body's immunity. The long-term mechanism of warts in relatively healthy people is not yet clear, and may be related to local or systemic immune dysfunction or immune tolerance.

Clinical manifestations of common warts

1. It started as a large papule with a large needle tip, and gradually expanded to a large or larger pea. It was round or polygonal, with a rough surface, obvious keratinization, and hard quality. It was grayish yellow, stained yellow, or stained brown, and continued to develop as a nipple. Tumor-like proliferation, rubbing or bumping prone to bleeding.

2. Occurs on fingers, back of hands, feet.

3. The number varies from one to many at the beginning, but it can grow to several to dozens later. Generally without conscious symptoms, occasional tenderness.

4. Mostly occur in adolescents, generally without symptoms, and occasional tenderness. The course of the disease is chronic and part of it can heal.

5. Plantar warts are common warts that occur on the soles of the feet. Due to local compression and friction, a yellow scab is formed on the surface. If this layer is removed with a knife, a white soft thorn-like wart can be seen, and small black spots are often scattered on the surface.

6. Occurring in the nail margin, the performance is simple keratosis, the typical verrucous lesions appear only when invaded the skin. If it spreads under the nails, it will cause the nails to rise, destroying the growth of the nails, causing cracks, pain, and secondary infections.

7. Symptoms before subsiding: Sudden itching, redness and swelling at the base of the wart, the damage suddenly becomes large, tends to be unstable, or individual warts can subside or small new warts occur.

8. Special type

(1) Filamentous warts: Occur in the eyelid, neck, palate, etc., and are mostly single, soft, filamentous protrusions.

(2) Finger warts: On the same soft foundation, a cluster of uneven finger-shaped protrusions occurs, with horny spines at the tip, varying in number, often on the scalp, or on the face and toes between.

Diagnosis of common warts

Diagnosis is based on typical clinical manifestations.

Common wart treatment

The main methods of treatment are to destroy warts, regulate local skin growth, and stimulate local or systemic immune responses, including systemic and local treatments.

Systemic treatment

(1) Traditional Chinese medicine and traditional Chinese medicines such as Pinggan Huoxue Fang, Zhi wart soup, purslane mixture, Banlangen injection, Bupleurum injection, etc.

(2) Interferon For multiple and intractable warts, interferon can be injected with the whole body or local lesions. Interferon alone is not effective.

2. Topical drug treatment

Since most patients with warts can subside within 1 to 2 years after onset, many patients will relapse even if they use deep destructive treatment. Therefore, the efficacy of various local treatments for warts should be carefully evaluated Some methods that can cause permanent scarring should not be used.

(1) Fluorouracil (5-FU) has a certain effect. Possible adverse reactions include local pain, cleft palate, edema, allergic reactions, tearing, pigmentation, and suppuration.

(2) Intralesional injection of bleomycin once a week, usually two to three times after the wart sheds, with few side effects.

(3) 0.7% cantharidin added to the same amount of collodion cotton and acetone solution, topical treatment of common nail warts, once every other day, it has a certain effect.

(4) 0.1% to 0.3% retinoic acid alcohol solution For topical application, 1 to 2 times a day, side effects include local mild burning sensation, redness, scaling, and pigmentation.

(5) 3% ophthalmamine ointment or 3% ophthalmamine dimethyl sulfoxide tincture.

(6) 0.5% podophyllotoxin 2 times a day for 3 consecutive days. If it can be tolerated, it can be used continuously for 4 to 5 days. If the wart does not fall off, you can use another course every other week.

(7) 5% imiquimod cream can be used for packet treatment of common warts or with salicylic acid.

(8) External use of 1% cidofovir gel or 2.5mg / ml intralesional injection is effective for many warts.

3. Photodynamic therapy

Systemic or local application of the photosensitizer aminolevulinic acid or aminoketovaleric acid (ALA) can cause local cell death after light irradiation, which can treat some common warts.

4. Physical therapy

Cryotherapy, electrocautery therapy, laser therapy, and infrared coagulation therapy are suitable for a small number of common warts.

5. Surgical resection

Easy to relapse after surgery.