색소 레이저 및 Bleomycin 병변내 주입 복합요법을 이용한 난치성 사마귀의 치료 효과

Abstract

Background : Some warts prove resistant to multiple therapies, particularly in an immunosuppressed patient. A previous study revealed that combination therapy with pulsed dye laser and intralesional bleomycin is effective for recalcitrant warts. Objective : The aim of this study is to confirm if the combination therapy with pulsed dye laser and intralesional bleomycin is effective for recalcitrant warts. Method : Fifteen patients, all with recalcitrant warts, were recruited. Two patients were on long-term immunosuppressant drugs. Twenty warts were treated in total. The warts were anaesthetized with local anesthetic cream, EMLAⓇ 5% cream, then treated with a pulsed dye laser (5 mm spot, fluence 9.5-10 J/cm2). Immediately following this bleomycin (1 mg/ml) was injected into the base of the warts. At 3-4 weeks after the last treatment, the warts were evaluated to assess clearance rate, total treatment numbers and side effects. Result : 1. Complete clearance was achieved in 17 out of 20 warts (85%). 2. Partial clearance was achieved in 3 out of 20 warts (15%). 3. Recalcitrant warts were cleared with an average of 1.95 treatments. 4. Recalcitrant warts in the immunosuppressed patients were cleared with an average of 2.0 treatments. 5. No significant side effects were observed. Conclusion : The combination therapy with the pulsed dye laser and intralesional bleomycin appears to be a safe, rapid, well tolerated, and successful treatment for recalcitrant warts. It also appears to be effective for recalcitrant warts in immunosuppressed patients.