Efficacy of intralesional bleomycin in treatment resistant viral
warts

Martyna Sławińska; Jakub Żółkiewicz; Krzysztof Pastuszak; Klaudia Zawadzka; Monika Sikorska; Roman Nowicki; Michał Sobjanek

doi:10.5114/dr.2022.123983

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

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4/2022
vol. 109

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abstract:

Original paper

Efficacy of intralesional bleomycin in treatment resistant viral warts

Martyna Sławińska

¹

,

Jakub Żółkiewicz

¹

,

Krzysztof Pastuszak

^{2, 3, 4}

,

Klaudia Zawadzka

^{5, 6}

,

Monika Sikorska

¹

,

Roman J. Nowicki

¹

,

Michał Sobjanek

¹

Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
Department of Algorithms and System Modelling, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gdansk, Poland
Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdansk, Gdansk, Poland
Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdansk, Gdansk, Poland
Hospital Pharmacy, University Clinical Centre, Gdansk, Poland
Hospital Pharmacy, Powiatowe Centrum Zdrowia Sp. z o.o., Kartuzy, Poland

Dermatol Rev/Przegl Dermatol 2022, 109, 272-290

DOI: https://doi.org/10.5114/dr.2022.123983

Online publish date: 2023/01/16

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Introduction
Optimal management of treatment-refractory viral warts caused by human papillomavirus is unknown. One of the treatment methods is intralesional bleomycin solution.

Objective
To determine risk factors for resistant viral warts (not responding to conventional treatments for ≥ 6 months), to determine the effectiveness and safety of intralesional bleomycin in a group of patients with viral warts resistant to conventional treatment methods, and to assess the utility of dermoscopy in monitoring treatment effects during intralesional bleomycin therapy.

Material and methods
The study group consisted of consecutive 12 adult patients with resistant viral warts treated with intralesional bleomycin (0,5 U/ml) at the Department of Dermatology, Venereology and Allergology, Medical University of Gdansk between July 2019 and December 2021. Inclusion criteria were age > 18 and previous unsuccessful treatment of viral warts with ≥ 2 methods used according to guidelines over a period of 6 months. The control group consisted of 8 adult patients who presented with viral warts of the total duration of less than 6 months with no previous treatment, and qualified for cryotherapy.

Results
Bleomycin showed 100% efficacy. Except for periprocedural pain, no side effects were observed. Dermoscopy proved to be effective in clinical evaluation of patients, as it allowed to differentiate wart remnants from eschar observed after bleomycin injection. In one patient we observed CD4+ lymphocytopenia at the inclusion stage, and no other risk factors of resistant warts could be identified, however a relatively small number of patients studied could influence this observation.

Conclusions
Intralesional bleomycin may be considered as possible therapeutic option in patients with therapy-resistant viral warts.

keywords:

Efficacy of intralesional bleomycin in treatment resistant viral warts

Martyna Sławińska 1 , Jakub Żółkiewicz 1 , Krzysztof Pastuszak 2, 3, 4 , Klaudia Zawadzka 5, 6 , Monika Sikorska 1 , Roman J. Nowicki 1 , Michał Sobjanek 1

viral warts, HPV, bleomycin, dermoscopy, dermatoscopy

Martyna Sławińska

¹

,

Jakub Żółkiewicz

¹

,

Krzysztof Pastuszak

^{2, 3, 4}

,

Klaudia Zawadzka

^{5, 6}

,

Monika Sikorska

¹

,

Roman J. Nowicki

¹

,

Michał Sobjanek

¹