Intralesional Cidofovir for Treating Recalcitrant Periungual Warts


eMediNexus    27 January 2023

Successful treatment of periungual warts is clinically challenging, as many are refractory or represented after conventional therapies. Using destructive therapies, like cryotherapy, may even result in permanent nail dystrophy. A recent series of nine cases in which intralesional cidofovir was used for recalcitrant periungual warts (mean of 2.7 treatments) showed: 


  • Improvement in the appearance of warts in 100% of patients.
  • Near to complete resolution in 77.8% of the patients.
  • Reports of few self-resolving local reactions, including pain, edema, erosion, blister formation and discoloration at the proximal nail fold.
  • Resolution of all reactions within weeks of treatment and requirements of no additional treatment. 


This study shows that intralesional cidofovir treatment of recalcitrant periungual warts is well-tolerated and provides unmatched results. The risks of traditional therapies to the nail direct the use of intralesional cidofovir as a first-line therapy for periungual warts. Randomized clinical trials in the future are necessary to demonstrate the effectiveness of intralesional cidofovir.


Source: Poppens M, Davis J. Intralesional cidofovir for the treatment of recalcitrant periungual warts. J Dermatolog Treat. 2022 Dec 1:1-10. 

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