Comparison of intralesional bleomycin versus salicylic acid 16.5% and lactic acid 16.5% combination paint in management of plantar warts

Salicylic and lactic acid (SAL) paint is commonly used to treat warts due to ease of application without any instrumentation. Intralesional bleomycin has been used for the treatment of warts since the 1970s with high efficacy even at low concentration. The aim of this study was to assess the efficacy of single dose of intralesional bleomycin in the treatment of plantar warts in comparison with a control group of similar sample receiving SAL paint application. Patients were randomly divided into two groups to receive either single dose of intralesional bleomycin injection or SAL paint application daily for maximum of two months. Plantar warts of the patients were assessed at baseline and with each return visit including a post-treatment follow-up of six months. Of the 100 patients enrolled in the study, 50 (50%) patients were treated with intralesional bleomycin, and 50 (50%) were treated with SAL paint. Out of total 441 treated warts in 100 patients, 198 (44.89%) warts were treated with intralesional bleomycin, and 243 (55.1%) warts were treated with SAL paint. The clearance rates in the context of number of patients and number of warts were 94% (47 out of 50) and 97.97% (194 out of 198) for bleomycin and 36% (18 out of 50) and 27.5% (67 out of 243) for SAL paint, respectively. Single dose of intralesional bleomycin injection is significantly more effective than SAL paint for the treatment of plantar warts.