Isolated limb infusion as a novel treatment for extensive plantar warts.
BACKGROUND
We describe the previously unreported use of isolated limb infusion (ILI) to treat extensive, bilateral plantar warts in a 54-year-old female. The warts had covered the weight-bearing surfaces of both feet for 10 years and had failed to respond to all previous treatments.


METHODS
A standard ILI technique was used to infuse melphalan and actinomycin D to the left leg. Circulation was maintained for 30 min. The limb was warmed and upon completion of the procedure was markedly hypoxic and acidotic. The contralateral limb was treated 6 months later.


RESULTS
At 5 weeks, a partial response with 80% disease clearance was observed. Pain impeded mobilisation until desquamation occurred 6 weeks postoperatively. There was little regrowth at 6 months.


CONCLUSIONS
Although invasive, ILI may represent a viable treatment option for resistant human papilloma virus-induced warts on the peripheries. Further research into this potential treatment tool is warranted.
Wilks
Daniel James
DJ
Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds LS1 3EX, UK.
Peach
Alan Howard Skyrme
AH
D003603:Cytotoxins / Q000008:administration & dosage*; D003609:Dactinomycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D007263:Infusions, Parenteral; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000188:drug therapy*; D014860:Warts / Q000188:drug therapy* / Q000473:pathology
D003603:Cytotoxins; D003609:Dactinomycin; D008558:Melphalan