Intralesional bleomycin in the treatment of cutaneous warts: a randomized clinical trial comparing it with cryotherapy.
BACKGROUND
Though not in regular practice, intralesional (IL) bleomycin has been used for the treatment of warts since the 1970s and on the other hand, till now cryotherapy is quite regularly used to treat warts.


OBJECTIVE
Our aim was to assess the evidence for the efficacy of IL bleomycin, in comparison with a control group of similar sample receiving cryotherapy, in the treatment of cutaneous warts.


METHODS
Patients were randomized using computer-generated codes to receive either cryotherapy (double freeze-thaw cycle) or IL bleomycin (0.1% solution with concurrent anesthesia) for a maximum of four treatments 3 weeks apart and a maximum of five warts treated in each visit for both groups. Patients had their warts measured at base-line and with each return visit including a post treatment follow-up that was 8 weeks apart from last treatment taken.


RESULTS
Of the 73 patients completing the study, 39 (53%) were treated with IL bleomycin and 34 (47%) were treated with cryotherapy. Out of 155 treated warts, 87 (56%) were treated with IL beomycin and 68 (44%) were treated with cryotherapy. The clearance rates in context of number of patients and number of warts were 94.9% and 97% for bleomycin and 76.5% and 82% for cryotherapy respectively (P < 0.05 by x(2) analysis and RR = 7.67).


CONCLUSIONS
IL bleomycin injection was significantly more effective than cryotherapy for treatment of cutaneous wart.
Department of Dermatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh. sabujdhar@gmail.com
S B
SB
Dhar
M M
MM
Rashid
Azmm
A
Islam
Msi
M
Bhuiyan
D000293:Adolescent; D000328:Adult; D001761:Bleomycin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D017679:Cryotherapy / Q000379:methods; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014860:Warts / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
D001761:Bleomycin