title: The use of diphenylcyclopropenone in the treatment of recalcitrant warts.
abstract: BACKGROUND
  The treatment of recalcitrant palmoplantar and periungual warts using topical immunotherapy with diphenylcyclopropenone (DPC) was reviewed retrospectively over a seven-year period.
  
  
  METHODS
  Two hundred eleven patients were sensitized during this time. The patients consisted of 90 males and 121 females and were between 5 and 78 years old. Twenty-three patients were lost to followup. Of the remaining, 4 were undergoing treatment at the time of evaluation, 1 patient failed sensitization, and 1 patient became pregnant. Four discontinued because of side effects, 3 because of financial reasons, and 18 patients discontinued treatment prior to completing the minimum required applications (defined as 6), producing a dropout rate of 12% (25/211). Three patients had additional treatment during the course of DPC and were not included in the study. The remaining 154 patients were classified as nonresponders or responders.
  
  
  RESULTS
  The responders consisted of 135 individuals (87.7%) that had complete clearance of warts. Reported adverse effects were local and included with pruritus (15.6%), with blistering (7.1%), and with eczematous reactions (14.2%). The majority of the patients tolerated the treatment very well. One patient developed local impetigo. Patients had an average of 5 treatments over a 6-month period.
  
  
  CONCLUSIONS
  Topical immunotherapy using DPC is an effective treatment option for recalcitrant warts. It should be considered as first-line treatment for warts based on its high response rate, absence of scarring, and painless application.
authors.affiliation: University of ALberta, Edmonton, Alberta, Canada.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Upitis
authors.forename: Alfons
authors.initials: A
authors.lastname: Krol
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000188:drug therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012871:Skin Diseases / Q000188:drug therapy*; D016896:Treatment Outcome; D014860:Warts / Q000188:drug therapy*
chemical_list: D003521:Cyclopropanes; D007166:Immunosuppressive Agents; C029402:diphenylcyclopropenone