A new and effective delivery system of bleomycin for the treatment of recalcitrant warts1

The effectiveness of intralesional bleomycin in the treatment of viral warts is well established. Various methods of delivering bleomycin into plantar warts have been decribed with success rates ranging from 60-90%. Its general acceptance in routine dermatological practice remains low, as needle methods are limited by local pain and potential risks to both the patients and operator. We describe a new delivery system for intralesional belomycin using a needle-less high velocity airjet. Its efficacy, safety and acceptance in patients with recalcitrant plantar warts were assessed in this study. Twenty three patients (11 males, 12 females) with 59 plantar warts have been treated to date. The warts have been present for at least 2 years and failed to respond to intensive conventional treatments including cryosurgery. Mean surface area pre-treatment was 1.3 sq cm. We use a high velocity jet with a plastic safety guard to administer an aqueous solution of bleomycin (0.1 ml of 1 mg/ml bleomycin intralesionally for each 0.25 sq cm of plantar wart).