Intralesional Cidofovir Shows Promise for Recalcitrant Warts in Children

Intralesional cidofovir is emerging as a potent treatment option for recalcitrant warts, particularly in pediatric populations, according to recent findings. ⁤While not a first-line therapy, this antiviral agent has demonstrated significant efficacy ⁤in patients who have failed to respond‌ to conventional treatments.

Promising Efficacy in Pediatric cases

A case series presented at the Society for Pediatric Dermatology (SPD) meeting highlighted the effectiveness of intralesional cidofovir in seven children aged 7 to 17 years. Thes participants had multiple cutaneous warts on their⁢ extremities that were resistant to standard therapies, including salicylic acid, cryotherapy, Candida ‌antigen⁤ injections, oral cimetidine, and pulsed​ dye laser.

The​ treatment involved injecting cidofovir (15 mg/mL) directly into each wart. doses ranged from 2 ⁣mg to 13.5 ‍mg per wart, with total session doses ​between 4.5 mg and 30 mg.‌ Pain management was required for six of ⁣the seven patients,utilizing lidocaine,ice ⁤application,or a Buzzy device with⁢ topical vapocoolant.The results were encouraging: three ⁣of‍ the ​seven ‌children achieved complete⁣ resolution of ‍their warts after just two treatment sessions. One patient with warts on⁣ both hands experienced resolution on one hand after⁢ five treatments, followed​ by a recurrence.‌ Despite eight additional sessions,​ the warts improved but did not fully resolve. ⁤Two patients were lost to follow-up after a single session,and one patient⁤ declined further treatment after one session with no observed enhancement.

Despite these varied outcomes, the authors concluded that this case series supports the growing evidence base for intralesional cidofovir as ‍a viable treatment for recalcitrant warts in children.

broader Evidence and Expert Opinion

The‍ pediatric findings align with broader research, including a study involving immunocompromised patients. This study⁣ reported that after a mean of ​3.4 treatments with intralesional cidofovir, 98% of warts showed improvement, and a remarkable 76% resolved wholly.

Moreover, a case series of nine adults with recalcitrant⁣ periungual warts ⁣demonstrated similar ‌efficacy.After an average of 2.7 ‍treatments, 77.8% of these⁢ patients achieved near-complete ​resolution, with minimal side effects.⁤ Notably, the appearance of warts improved in all participants in this adult series.

Dr. Iloabuchi, who presented the pediatric findings, emphasized that cidofovir is reserved for cases where standard therapies have failed.

Luke S. Johnson,​ MD, an associate professor‌ in the Department of Dermatology at the University of Utah, who was not involved⁢ in the study, commented on⁢ the findings. He agreed that the results bolster the case for intralesional cidofovir. “Anecdotally, some of my colleagues are using this in adults with decent success,” Dr. Johnson stated.⁤ He noted that accessibility and cost can be challenges, and that a comparison between topical and intralesional cidofovir is still needed.

“Head-to-head studies⁣ are pretty uncommon in our world,” Dr. Johnson‌ added. “I‍ would use ​it if I could‌ get it and ‍be reimbursed for it.”

While the⁤ current‍ evidence ⁢is promising, Dr. Iloabuchi stressed the need for larger studies with more patients and longer follow-up periods to further solidify the⁢ role of intralesional cidofovir in wart management.

The study was independently supported. Iloabachi reported having no relevant financial relationships. Johnson had‌ no relevant disclosures.