title: Isolated limb infusion as a novel treatment for extensive plantar warts.
abstract: 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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds LS1 3EX, UK.
authors.forename: Daniel James
authors.initials: DJ
authors.lastname: Wilks
authors.forename: Alan Howard Skyrme
authors.initials: AH
authors.lastname: Peach
mesh_terms: 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
chemical_list: D003603:Cytotoxins; D003609:Dactinomycin; D008558:Melphalan