Korean J Dermatol.  2024 Mar;62(3):129-135.

Exploring the Efficacy and Safety of Intralesional Acyclovir for Treating Periungual and Palmoplantar Warts

• Min KH
• Yoo EH
• Koo HYR
• Yun SY
• Choi JY
• Yu DS
• Lee YB

Abstract

Background
Warts are benign hyperkeratotic proliferative skin lesions caused by the human papillomavirus (HPV). Traditional destructive treatments, such as cryotherapy, have limited effectiveness and can lead to substantial adverse effects. Acyclovir, an antiviral agent against human herpes viruses, may be effective in the treatment of warts, as HPV is also a DNA virus.
Objective
This study aimed to evaluate the efficacy of intralesional acyclovir for the treatment of warts.
Methods
We conducted a retrospective study of 21 patients diagnosed with periungual or palmoplantar warts who were treated with intralesional acyclovir (25 mg/mL) injections between January 2022 and December 2022. The treatment was repeated at 3- to 4-week intervals, and the therapeutic effect was evaluated one month after the final treatment session.
Results
Complete resolution of warts was observed in nine patients (42.9%), partial response in seven patients (33.3%), and no response in five patients (23.8%). Injection-related transient pain and hemorrhage were reported by all patients, with a hemorrhagic crust observed in one patient (4.76%) and transient onycholysis noted in another patient (4.76%). No permanent nail deformities have been reported.
Conclusion
Intralesional acyclovir is a potentially effective and safe treatment modality for periungual and palmoplantar warts.

Keyword

Acyclovir; Intralesional; Warts