Compared therapeutic efficacy between intralesional bleomycin and cryotherapy for common warts: A randomized clinical trial

Abstract

In spite of many available studies on bleomycin and cryotherapy in treating warts, little head to head research is done to compare efficacy of these treatments. Our aim was to compare the therapeutic effects of intralesional bleomycin and cryotherapy on common warts of the hands and feet. In this clinical trial 44 patients above 12 years of age referred to the dermatology clinic of Bouali University Hospital were enrolled. The patients were required to have warts on at least two symmetric limbs (hands or feet). The warts located on right and left limbs of each patient were examined and counted. Each patient received both cryotherapy and intralesional bleomycin on his or her warts. The two treatment types were randomly allocated to either right sided or left sided warts. Each patient was evaluated at 2 week intervals and retreated if necessary up to three times. Data were analyzed by SPSS 11 and EPI Info 2002 statistical packages. The mean number of warts was 5.2 on upper limbs and 4.6 on lower limbs. In 86.4 percent of the cases all warts on the limb side treated by intralesional bleomycin were cleared compared with 68.2 % for cryotherapy (P<0.05). Relative risk for the effect of bleomycin compared to cryotherapy in this regard was 1.27 (1<RR<1.6). We found bleomycin to have a clearance rate equal to 87.6 percent of warts, compared to 72.3 percent by cryotherapy. Relative risk for therapeutic effect of bleomycin compared to cryotherapy in this regard was 1.23 (1.11<RR<1.33). Intralesional bleomycin is more effective than cryotherapy in treating warts on hands and feet.