therapeutic evaluation of intralesional injection of bleomycin sulfat e in the treatment of resistant warts

from june 1992 to march 1993, a group of patients suffering from different types of warts were treated with intralesional injections of bleomycin sulfate. this study reviews the literature concerning this modality of treatment and the pathophysiology and immunohistopathology of warts and options for treatment. in this prospective study, a combination of a i mg/ml solution of bleomycin in distilled water and lidocaine 2% (in equal portions) was injected in 22 patients. no patient received more than 2ml of the solution. eighty-four of 95 warts (88.4%) showed complete resolution after 1-3 bleomycin injections, while 10 warts (10.5%) showed incomplete resolution. in only one plantar wart did bleomycin fail to elicit any therapeutic response (1.1%).the cure rate was 96.3% for periungual warts, 84.6% for palmoplantar warts, and 75% for warts located on the extremities. the responsive warts developed a hemorrhagic eschar that healed without scarring. no systemic side-effects were observed but a mild transient pigmentary change was seen at the injection site of one palmar wart. it is concluded that this form of treatment for resistant warts is safe, reliable and well accepted by the patients if used in the dose mentioned.