Cutaneous warts are a very common reason for consultation in the everyday practice of dermatologists. Although multiple therapies are available, none of them guarantees improvement and cutaneous warts can become a recalcitrant, disabling, medical problem. Regarding this issue Dr. Megan N. Landis and collaborators have just published their personal experience with a 59-year-old, otherwise healthy lady, who suffered from recalcitrant plantar warts. The lesions had been present for 5 years, and they had been treated with multiple consecutive treatments without success: liquid nitrogen cryotherapy, topical imiquimod 5%, 40% salicylic acid, pulsed dye laser, oral cimetidine, topical tretinoin 0.025%, occlusion by 40% salicylic acid and intralesional bleomycin 1% injections. Based on isolated previous reports Dr. Megan N. Landis et al decided to administer 3 doses of the recombinant quadrivalent human papillomavirus vaccine types (6,11,16 and 18) at 0,2, and 6 months (from July 2010 to January 2011). By April 2011 the lesions had completely resolved.
Of course, the authors underline the possibility of spontaneous resolution. However, HPV vaccines may play a role when managing recalcitrant warts in which other therapies do not show efficacy. Certainly, clinical trials are needed to study the issue in depth in terms of efficacy and safety, and to define which patients should be treated.
Do you have a personal experience in this field?.
Landis MN, Lookingbill DP, Sluzevich JC.
J Am Acad Dermatol. 2012 Aug;67(2):e73-4.