REFRACTORY SUBUNGUAL WARTS

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What treatment options are there for subungual warts if cryotherapy and hyfrecation have failed?
—Kenneth Lowrance, RN, FNP-C, Clifton, Tex.

Warts are one of the most stubborn dermatologic conditions. I often use repeated courses of cryotherapy in combination with OTC salicylic acid. Use of duct tape is another adjunctive therapy option. In addition, immunotherapy with Candida antigen is effective. In this approach, Candida antigen is diluted with plain lidocaine and injected into one or two of the largest warts. This procedure can be repeated monthly. When successful, it can clear treated as well as untreated warts. Intralesional bleomycin is another option, but this therapy can be quite painful.
—Jeffrey M. Weinberg, MD (116-14)

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