Skip to main content

Advertisement

Log in

Efficacy of a bleomycin microneedle patch for the treatment of warts

  • Clinical Trial
  • Published:
Drug Delivery and Translational Research Aims and scope Submit manuscript

Abstract

Warts are a common skin disease caused by infection of the human papilloma virus. Most treatments involving physical destruction of the infected cells, such as cryotherapy and electrocautery, are limited by intense pain, failure, or recurrences. Our aim was to compare the therapeutic effects of a newly developed bleomycin microneedle patch with cryotherapy in the treatment of warts. Forty-two patients with more than two wart lesions were included in the study. The two treatment modalities were randomly applied to different warts on each patient. Treatment efficacy was assessed using the Physician’s Global Assessment (PGA) and the Patient’s Global Assessment (PaGA). Mean PGA and PaGA scores were not significantly different between cryotherapy and bleomycin microneedle patch treatment. It was also determined that the mean size of all the warts treated with either modality shrank about equally at weeks 8 and 16 after initial treatment. Thus, treatment efficacy of the bleomycin microneedle patch was comparable to that of conventional cryotherapy. According to a visual analogue scale of pain, bleomycin microneedle patch treatment was significantly less painful than cryotherapy (p < .0001). In addition, use of the bleomycin microneedle patch was more tolerable for patients who were reluctant to receive the painful treatment. Thus, the bleomycin microneedle patch can be an effective, convenient, and innovative treatment modality for warts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Bacelieri R, Johnson SM. Cutaneous warts: an evidence-based approach to therapy. Am Fam Physician. 2005;72(4):647–52.

    PubMed  Google Scholar 

  2. Willian TGB James D, Dirk M. Elston, Andrew’s diseases of the skin: clinical dermatology. 2011.

  3. Lee JR, Youn JH, Roh JY. Intralesional vincristine combined with cryotherapy for recalcitrant verrucas. Dermatol Ther. 2011;24(3):380–3. https://doi.org/10.1111/j.1529-8019.2011.01425.x.

  4. Berth-Jones J, Bourke J, Eglitis H, Harper C, Kirk P, Pavord S, et al. Value of a second freeze-thaw cycle in cryotherapy of common warts. Br J Dermatol. 1994;131(6):883–6. https://doi.org/10.1111/j.1365-2133.1994.tb08594.x.

  5. Saitta P, Krishnamurthy K, Brown LH. Bleomycin in dermatology: a review of intralesional applications. Dermatol Surg. 2008;34(10):1299–313. https://doi.org/10.1111/j.1524-4725.2008.34281.x.

    CAS  PubMed  Google Scholar 

  6. James MP, Collier PM, Aherne W, Hardcastle A, Lovegrove S. Histologic, pharmacologic, and immunocytochemical effects of injection of bleomycin into viral warts. J Am Acad Dermatol. 1993;28(6):933–7. https://doi.org/10.1016/0190-9622(93)70133-E.

    Article  CAS  PubMed  Google Scholar 

  7. Yamamoto T. Bleomycin and the skin. Br J Dermatol. 2006;155(5):869–75. https://doi.org/10.1111/j.1365-2133.2006.07474.x.

    Article  CAS  PubMed  Google Scholar 

  8. Shelley WB, Shelley ED. Intralesional bleomycin sulfate therapy for warts. A novel bifurcated needle puncture technique. Arch Dermatol. 1991;127(2):234–6. https://doi.org/10.1001/archderm.1991.01680020102014.

    Article  CAS  PubMed  Google Scholar 

  9. Bunney MH, Nolan MW, Buxton PK, Going SM, Prescott RJ. The treatment of resistant warts with intralesional bleomycin: a controlled clinical trial. Br J Dermatol. 1984;111(2):197–207. https://doi.org/10.1111/j.1365-2133.1984.tb04044.x.

    Article  CAS  PubMed  Google Scholar 

  10. Shumer SM, O’Keefe EJ. Bleomycin in the treatment of recalcitrant warts. J Am Acad Dermatol. 1983;9(1):91–6. https://doi.org/10.1016/S0190-9622(83)70112-X.

    Article  CAS  PubMed  Google Scholar 

  11. Amer M, Diab N, Ramadan A, Galal A, Salem A. Therapeutic evaluation for intralesional injection of bleomycin sulfate in 143 resistant warts. J Am Acad Dermatol. 1988;18(6):1313–6. https://doi.org/10.1016/S0190-9622(88)70140-1.

    Article  CAS  PubMed  Google Scholar 

  12. Munn SE, Higgins E, Marshall M, Clement M. A new method of intralesional bleomycin therapy in the treatment of recalcitrant warts. Br J Dermatol. 1996;135(6):969–71. https://doi.org/10.1046/j.1365-2133.1996.d01-1104.x.

    Article  CAS  PubMed  Google Scholar 

  13. Agius E, Mooney JM, Bezzina AC, Yu RC. Dermojet delivery of bleomycin for the treatment of recalcitrant plantar warts. J Dermatolog Treat. 2006;17(2):112–6. https://doi.org/10.1080/09546630600621987.

    Article  CAS  PubMed  Google Scholar 

  14. Hayes ME, O’Keefe EJ. Reduced dose of bleomycin in the treatment of recalcitrant warts. J Am Acad Dermatol. 1986;15(5):1002–6. https://doi.org/10.1016/S0190-9622(86)70264-8.

    Article  CAS  PubMed  Google Scholar 

  15. Miller RA. Nail dystrophy following intralesional injections of bleomycin for a periungual wart. Arch Dermatol. 1984;120(7):963–4. https://doi.org/10.1001/archderm.1984.01650430153030.

    Article  CAS  PubMed  Google Scholar 

  16. Urbina Gonzalez F, Cristobal Gil MC, Aguilar Martinez A, Guerra Rodriguez P, Sanchez de Paz F, Garcia-Perez A. Cutaneous toxicity of intralesional bleomycin administration in the treatment of periungual warts. Arch Dermatol. 1986;122(9):974–5. https://doi.org/10.1001/archderm.122.9.974.

    Article  CAS  PubMed  Google Scholar 

  17. Lee HS, Ryu HR, Roh JY, Park JH. Bleomycin-coated microneedles for treatment of warts. Pharm Res. 2017;34(1):101–12. https://doi.org/10.1007/s11095-016-2042-x.

    Article  CAS  PubMed  Google Scholar 

  18. Park J-H, Allen MG, Prausnitz MR. Biodegradable polymer microneedles: fabrication, mechanics and transdermal drug delivery. J Control Release. 2005;104(1):51–66. https://doi.org/10.1016/j.jconrel.2005.02.002.

    Article  CAS  PubMed  Google Scholar 

  19. Ma Y, Boese SE, Luo Z, Nitin N, Gill HS. Drug coated microneedles for minimally-invasive treatment of oral carcinomas: development and in vitro evaluation. Biomed Microdevices. 2015;17:1–14.

    Article  Google Scholar 

  20. Rebecca EL, Lutton EM, Woolfson D, Donnelly RF. Microneedle arrays as transdermal and intradermal drug delivery systems: materials science, manufacture and commercial development. Mater Sci Eng: R: Rep. 2017;104:1–32.

    Google Scholar 

  21. Zhang Y, Brown K, Siebenaler K, Determan A, Dohmeier D, Hansen K. Development of lidocaine-coated microneedle product for rapid, safe, and prolonged local analgesic action. Pharm Res. 2012;29(1):170–7. https://doi.org/10.1007/s11095-011-0524-4.

    Article  PubMed  Google Scholar 

  22. Zhao X, Coulman SA, Hanna SJ, Wong FS, Dayan CM, Birchall JC. Formulation of hydrophobic peptides for skin delivery via coated microneedles. J Cotrol Rel. 2017;In-press.

  23. Graham GF, Barham KL. Cryosurgery. Curr Probl Dermatol. 2003;15(6):229–50. https://doi.org/10.1016/S1040-0486(03)00077-2.

    Article  Google Scholar 

  24. Takigawa M, Oku T, Ginoza M, Yamada M, Yamamoto T, Kobayashi I. Treatment of viral warts with pressure-sensitive adhesive tape containing bleomycin sulfate. Arch Dermatol. 1985;121(9):1108. https://doi.org/10.1001/archderm.1985.01660090022008.

    Article  CAS  PubMed  Google Scholar 

  25. Sardana K, Garg V, Relhan V. Complete resolution of recalcitrant periungual/subungual wart with recovery of normal nail following “prick” method of administration of bleomycin 1. Dermatol Ther. 2010;23(4):407–10. https://doi.org/10.1111/j.1529-8019.2010.01341.x.

    Article  PubMed  Google Scholar 

  26. Deshmukh NS, Belgaumkar VA, Mhaske CB, Doshi BR. Intralesional drug therapy in dermatology. Indian J Dermatol Venereol Leprol. 2017;83(1):127–32. https://doi.org/10.4103/0378-6323.190870.

    Article  PubMed  Google Scholar 

  27. C.W.K Won Ho Kim, Kwang Ho Kim, Kwang Joong Kim. Intralesional bleomycin therapy using a lancet in the treatment of recalcitrant warts. Ann Dermatol. 2005;17:53–57.

  28. Kruter L, Saggar V, Akhavan A, Patel P, Umanoff N, Viola KV, et al. Intralesional bleomycin for warts: patient satisfaction and treatment outcomes. J Cutan Med Surg. 2015;19(5):470–6. https://doi.org/10.1177/1203475415576860.

Download references

Funding

This research was supported by the Gachon University Gil Medical Center (Grant number: 2013-47), a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea, and by the Technology Innovation Program (10067809, Development of vaccine formulation and patient-convenient vaccine microneedle) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Jung-Hwan Park or Joo Young Roh.

Ethics declarations

The study protocol was approved by the institutional review board (GDIRB2013-16) of Gil Medical Center and conformed to the principles outlined in the Declaration of Helsinki. Written informed consent was obtained from all subjects before they were enrolled in the study.

Conflict of interest

Authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ryu, H.R., Jeong, HR., Seon-Woo, HS. et al. Efficacy of a bleomycin microneedle patch for the treatment of warts. Drug Deliv. and Transl. Res. 8, 273–280 (2018). https://doi.org/10.1007/s13346-017-0458-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13346-017-0458-4

Keywords

Navigation