Bleomycin injection for warts

drorr · Dec 1, 2007

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hi
do pepole have experience with this therapy?
dror

Admin2 · Oct 26, 2012

Related:
Dermojet delivery of bleomycin for plantar warts
Cutaneous Warts: An Evidence-Based Approach to Therapy
Other thread tagged with verruca

NewsBot · Oct 26, 2012

Successful treatment of plantar warts with very diluted bleomycin using a translesional multipuncture technique: pilot prospective study.
Alghamdi KM, Khurram H.
J Cutan Med Surg. 2012 Jul-Aug;16(4):250-6.

BACKGROUND:
Plantar warts are common and often painful. Treatment of plantar warts is difficult and requires multiple treatments. Several clinical trials have proven the efficacy of bleomycin, but relatively high concentrations have been required and considerable side effects have been experienced.

OBJECTIVE:
To evaluate the efficacy and safety of low-concentration (0.1 U/mL) bleomycin using a translesional injection technique for the treatment of plantar warts.

METHODS:
The study included 23 patients with single or multiple plantar warts. Very low-concentration bleomycin was injected into a single wart or the largest plantar wart in the case of multiple lesions. Injections were performed at 4-week intervals until resolution of the warts or development of side effects. The translesional multipuncture technique was used.

RESULTS:
Thirteen patients were male (56.5%), and the mean age was 27.7 years. The results revealed complete clearance of warts in 17 of 23 (74%) patients, partial response in 1 (4.3%) patient, and no response in 3 (13%) patients. Recurrence was observed in 2 patients at 3 months of follow-up. Among those two, one patient showed complete clearance after the second injection at 6 months of follow-up. All patients were followed for 6 months after the initial treatment. No significant long-term adverse effects were noted. Only three patients (13%) had localized moderate pain for 2 to 3 days after the injection.

CONCLUSION:
Translesional injection by very low-concentration (0.1 U/mL) bleomycin appears to be a simple, effective, and safe treatment modality for plantar warts.
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NewsBot · Jun 26, 2014

Efficacy of Intralesional Bleomycin in the Treatment of Resistant Warts
Mir-Hadi Aziz-Jalali et al
J Skin Stem Cell. 2014 May; 1(1): e18875. DOI: 10.5812/jssc.18875

Background: Warts are benign tumors of the skin and mucosa and are caused by human papilloma virus (HPV). They are one of the most common skin diseases found mainly in children and adolescents. Although most of the warts disappear spontaneously or respond to the usual therapeutic measures, resistant forms of the warts impose a problem in dermatology. Intralesional injection of bleomycin has been tried in the treatment of resistant warts with variable results in different studies.
Objectives: This study aimed to assess the efficacy of intralesional injection of bleomycin in resistant warts.
Patients and Methods: In this cross-sectional study, a total of 130 warts in 30 patients were treated with 1 mg/mL intralesional injection of bleomycin. Patients received one to three doses of bleomycin every four weeks, and were followed for six months. Response to the treatment was categorized as complete resolution, partial resolution, and nonresponsive. We employed SPSS version 13 to perform t test and analysis of variance (Anova) as statistical methods for analyzing the data.
Results: Out of 130 warts, 126 (97%) cases showed resolution after bleomycin injections. Ninety-five warts (73%) showed complete resolution and 31 (24%) cases showed incomplete resolution. The cure rate (80%) was better in warts with the size smaller than 20 mm in diameter in comparison with larger lesions (46%). After six months follow-up, 7 patients showed recurrence. Recurrence was seen more among those with greater number of warts.
Conclusions: This form of treatment for resistant warts would be reliable, safe, and acceptable to the patients if it is performed under care and with proper dose and concentration.
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NewsBot · Nov 7, 2015

Intralesional Bleomycin for Warts: Patient Satisfaction and Treatment Outcomes.
Kruter L et al
J Cutan Med Surg. 2015 Sep-Oct;19(5):470-6

BACKGROUND:
The treatment of warts is challenging with regards to both tolerability and efficacy.
OBJECTIVE:
Ascertain the efficacy, tolerability, and patient satisfaction of intralesional bleomycin in the treatment of warts.
METHODS:
Retrospective chart review followed by telephone interviews with patients from university-based dermatology referral centers.
RESULTS:
Seventy-four percent (34/46) of patients had complete resolution (CR) of all warts. Of 34 patients who experienced CR, an average of 1.7 treatments were required. Pain experienced during the procedure and recovery, irrespective of outcome, was rated 5.8 out of 10 (range, 1-10; SD, 2.72; SEM, 0.40). Approximately 70% of patients had pain that lasted less than 2 days after treatment. Seventy-eight percent (36/46) of patients in the study were satisfied with treatment and would recommend it to others.
CONCLUSION:
Patients felt bleomycin to be an effective treatment modality for warts, offering high rates of CR in lesions resistant to more traditional therapies.
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NewsBot · Nov 20, 2016

Bleomycin-Coated Microneedles for Treatment of Warts.
Lee HS et al
Pharm Res. 2016 Nov 17.

PURPOSE:
Bleomycin-coated microneedles were devised for delivery of bleomycin into the sub-epidermal skin layer for the treatment of warts in order to provide patient convenience and reduce patient pain and fear.
METHOD:
Poly-lactic-acid (L-PLA) microneedles were fabricated by a molding process and then the tips were partially coated using a dip-coating method based on a microstructure well. The mechanical strength of the pre-coated polymer microneedles was observed by inserting them in porcine foot and back skin. The holes were stained with trypan blue and the mechanical failure of the microneedles was investigated using a scanning electron microscope (SEM). The initial distribution of a model drug using microneedles was compared with distribution by intralesional injection. The amount of drug leaked below the skin using microneedles was measured and compared with that leaked by intralesional injection. The pharmacokinetic properties of bleomycin-coated microneedles were studied. The bleomycin remaining on the coated microneedles after the in vivo pharmacokinetic study was measured.
RESULTS:
Bleomycin was successfully coated on the tips of L-PLA microneedles. More than 80% of the bleomycin dissolved into the skin in vitro within 15 min. L-PLA microneedles possessed sufficient mechanical strength to penetrate skin with a thick stratum corneum. Compared to intralesional injection, tip-coated microneedles were more effective in distributing a drug into the sub-epidermal skin layer. A pharmacokinetic study of bleomycin-coated microneedles showed 50 min of Tmax.
CONCLUSIONS:
Bleomycin-coated microneedles appeared to be a convenient and painless alternative to conventional intralesional injection of bleomycin. The microneedles delivered bleomycin into the targeted dermal layer regardless of body site. Bleomycin-coated microneedles therefore provide a suitable method for the treatment of warts.
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NewsBot · Aug 26, 2017

Successful treatment of plantar warts with intralesional bleomycin and electroporation: pilot prospective study.
Pasquali P, Freites-Martinez A, Gonzales S, Spugnini EP, Baldi A.
Dermatol Pract Concept 2017;7(3):4.

Background: Numerous studies have been performed to evaluate the efficacy of intralesional bleomycin for the treatment of warts with inconsistent result. Nevertheless, it is well known that the cytotoxicity of bleomycin can be enhanced in vivo by 300 to 700-fold by electroporation.
Objective and Methods: In this article, we present an interventional, one-center, prospective case series, clinical trial of the effectiveness of intralesional bleomycin combined with electroporation for the treatment of plantar warts, in comparison to the use of intralesional bleomycin alone.
Results: The study’s cohort included 12 men and 10 women, with a mean age of 53.8 years. A total of 22 warts were treated. In dividing the patients in two groups (complete remission against all the others) and analyzing the different outcomes in the two arms of patients, a statistical significant difference was found (p=0.0015), proving a greater efficacy of the treatment with bleomycin combined with ECT as opposed to bleomycin alone. Electroporation was always well tolerated by the patients with no discomfort.
Conclusions: This study serves as a basis for the application of novel protocols in the treatment of different benign and locally malignant skin lesion by means of electroporation.
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NewsBot · Apr 28, 2018

Intralesional bleomycin injection vs microneedling‐assisted topical bleomycin spraying in treatment of plantar warts
Mohamed R. Al‐Naggar MD Ahmad S. Al‐Adl MD Ali R. Rabie MD Mahmoud R. Abdelkhalk MD Mohamed L. Elsaie MD
JCD: 23 April 2018

Background
Warts, or verrucae, are benign epithelial profilerations of skin and mucosa caused by infection with HPV and poses a challenge to treat.

Objective
To compare between single and microneedling‐assisted multipuncture techniques of intralesional application in treatment of plantar warts.

Methods
The study included 60 Patients who were divided into two groups (A&B). Each group consisted of (30) patients. Group (A) subjects received intralesional bleomycin with a single injection using syringe needle. For Group (B) subjects, we combined microneedling with topical spraying of bleomycin (MN + Bleo) and followed by occlusion for 2 hours.

Results
The results revealed complete clearance of warts in 21 patients in group (A) (70%) whom were treated by intralesional (IL) bleomycin vs 25 patients (83.3%) in group (B) whom were treated by spraying of bleomycin following microneedling. Side effects other than pain, erythema, and transient induration were relatively infrequent, and no nail changes or Raynaud's phenomenon was observed in both groups.

Conclusion
We established a good safety and efficacy profile for bleomycin in plantar wart treatment and we demonstrated that microneedling followed by bleomycin spraying had a higher clearance and proved less painful as opposed to bleomycin injection.
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alessandro costa · Jul 5, 2018

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764803/

NewsBot · May 14, 2020

Combined therapy of plantar warts with topical bleomycin and microneedling: a comparative controlled study‏.
Gamil HD et al
J Dermatolog Treat. 2020 May;31(3):235-240

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group‏.Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion‏.
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NewsBot · Oct 25, 2021

Intralesional Bleomycin for the Treatment of Resistant Palmoplantar and Periungual Warts
Suchana Marahatta et al
Dermatology Research and Practice / 2021

Introduction. Periungual, palmar, and plantar warts are difficult to treat with poor treatment response. Intralesional (IL) bleomycin has shown promising results for their treatment in a few reports. However, we need further evidence before opting it for treating difficult sites and resistant warts. Hence, we conducted this study to assess the efficacy and safety of IL bleomycin for the treatment of resistant palmoplantar and periungual warts. Methods. In this retrospective study, we included all patients who were given IL bleomycin for warts over a year. Maximum three sittings of bleomycin (1 mg/ml) were given monthly, and they were followed up for 3 months after the procedure. The response was categorized as complete, near-complete, significant, moderate, mild, and no clearance for 100%, 75–99%, 50–74%, 25–49%, 1–25%, and 0% clearance, respectively. Results. Out of 29 patients, follow-up details were available only in 19 patients (53 warts). The mean duration was 2.5 ± 1.47 years. The number of past interventions ranged from 2–4. Wart clearance after the first intervention was complete in 36.84%, near-complete in 26.31%, significant in 26.31%, and moderate in 10.53%. Wart clearance after the last intervention was complete in 89.47% and near-complete in 10.52% of patients. However, during 3 months of follow-up after the last injection, 15.78% had a recurrence. None of them had severe local and systemic side effects. Conclusions. IL bleomycin could be a better treatment option for the treatment of resistant and difficult warts. However, we observed a higher recurrence rate even in a shorter follow-up. Hence, we need further studies with larger samples.
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Bleomycin injection for warts

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Bleomycin injection for warts

drorr Welcome New Poster

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

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alessandro costa Active Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Bleomycin for the treatment of plantar hard corns

Pulsed dye laser and intralesional bleomycin for the treatment of recalcitrant cutaneous warts

Dermojet delivery of bleomycin for plantar warts

Injection therapy for ingrown toenails

Intra-articular injections of the first metatarsophalangeal joint

Cortisone injection for gout after tibial sesamoidectomy

Saline water and lidocaine injection treatment of intractable plantar keratoma

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