title: Vagarious successful treatment of recalcitrant warts in combination with CO2 laser and imiquimod 5% cream.
abstract: BACKGROUND
  Imiquimod 5% cream is widely regarded as a safe and effective option when treating recalcitrant warts, owing to the ointment's negligible side effects. However, our observations highlighted case of a patient incurring severe adverse reactions due to application of the cream, although the treatment proved successful in curing recalcitrant warts which had developed on the external auditory canal and external ear.
  
  
  METHODS
  All lesions were entirely removed with short-pulsed CO2 laser. As soon as the wound-healing process was completed, imiquimod 5% cream was self-applied on the healing wounds once daily for 5 days per week in a total of 2 weeks.
  
  
  RESULTS
  The patient appeared normal after the CO2 laser treatment and experienced severe redness, itching, exudation, and incrustation after a 2-week imiquimod 5% cream therapy. All lesions showed no recurrence during the 12-month followed-up process.
  
  
  CONCLUSIONS
  We concluded that a feasible treatment modality to cure recalcitrant cutaneous warts is in combination of CO2 laser and imiquimod. Immunoenhancement plays an important role in the treatment of recalcitrant warts.
authors.affiliation: Department of Plastic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou , P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zeng
authors.forename: Yi-Qing
authors.initials: YQ
authors.lastname: Zheng
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000279:Administration, Cutaneous; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D004890:Erythema; D005260:Female; D006801:Humans; D000077271:Imiquimod; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D014860:Warts / Q000188:drug therapy* / Q000532:radiotherapy*
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod
keywords: CO2 laser; imiquimod; treatment; viral warts