Cutaneous Toxicity of Intralesional Bleomycin Administration in the Treatment of Periungual Warts

Abstract

<h3>To the Editor.—</h3> The treatment of recalcitrant warts is a common problem, and there have been several reports claiming the efficacy of intralesional bleomycin sulfate in their management.^1-4 We describe herein a patient with periungual warts treated with intralesional administration of bleomycin sulfate, followed by fingernail loss in involved fingers. To our knowledge, only one case has been reported.⁵In our case, no radiotherapy was previously used and no fingernail regrowth was seen after six months. <h3>Report of a Case.—</h3> A 15-year-old girl was seen in March 1985, with a two-year history of periungual warts on the distal phalanx of second and third fingers of the right hand. She had been treated repeatedly with numerous topical keratolytic agents with no response. Within a 40-day interval, two intralesional bleomycin sulfate injections (0.15 U each) were administered. The patient only experienced mild local pain which was well tolerated. No fingernail