Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil.
Faculdade de Medicina do ABC, Santo Andre, Brazil.
J Eur Acad Dermatol Venereol. 2019 Dec;33(12):2349-2354. doi: 10.1111/jdv.15815. Epub 2019 Aug 12.
Ungual warts are considered the most common benign nail tumour, and they are caused by the human papillomavirus. Despite the numerous treatments reported in the medical literature, ungual warts are considered frustrating, with high relapse rates and a potential risk of nail dystrophy. Bleomycin is a therapeutic option showing a good safety profile and high cure rates.
To evaluate the efficacy of electrochemotherapy using intralesional bleomycin for the treatment of ungual warts in comparison with intralesional bleomycin alone and describe the side-effects related to the use of both techniques.
This was a prospective, randomized, double-blind, controlled clinical trial. Forty-four 18- to 60-year-old female and male patients with ungual warts of only one finger were included. The patients were divided into two treatment groups: GA - intralesional bleomycin; and GB - electroporation and intralesional bleomycin. Following a single application, the patients were followed up for 180 days.
The patients' mean age was 36 years for GA and 37 years for GB. Most patients were female (68%). Of 22 patients in GA completing the study, 11 (50%) achieved the cure, while 18 (85.7%) of 21 patients completing the study in GB showed cure. A significant association of patients with or without cure after the GA and GB treatments (P = 0.022) was observed. None of the patients in either group had systemic side-effects. Independent of the technique used, all the participants considered the adverse effects tolerable.
The intralesional use of bleomycin associated with electroporation for the treatment of ungual warts (both periungual and subungual) showed a statistically superior cure when compared with intralesional bleomycin alone. Side-effects were more frequently observed in the electrochemotherapy with bleomycin group than in the bleomycin monotherapy group.
甲疣被认为是最常见的良性甲肿瘤，由人乳头瘤病毒引起。尽管医学文献中有许多治疗方法报道，但甲疣仍然令人沮丧，复发率高，有潜在的指甲营养不良风险。平阳霉素是一种治疗选择，具有良好的安全性和高治愈率。
评估电化学疗法联合平阳霉素局部注射治疗甲疣的疗效，并与单纯平阳霉素局部注射进行比较，同时描述两种方法相关的副作用。
这是一项前瞻性、随机、双盲、对照临床试验。纳入了 44 名 18-60 岁的女性和男性单指指端甲疣患者。患者分为两组：GA - 平阳霉素局部注射；GB - 电穿孔联合平阳霉素局部注射。单次治疗后，对患者进行 180 天的随访。
GA 组患者的平均年龄为 36 岁，GB 组为 37 岁。大多数患者为女性（68%）。GA 组完成研究的 22 名患者中，11 名（50%）治愈，GB 组完成研究的 21 名患者中，18 名（85.7%）治愈。GA 和 GB 治疗后治愈患者的比例存在显著关联（P = 0.022）。两组均无系统性副作用。无论使用何种技术，所有参与者都认为副作用可耐受。
平阳霉素局部注射联合电穿孔治疗甲疣（包括甲周和甲下）的治愈率明显优于单纯平阳霉素局部注射。与平阳霉素单药治疗组相比，电化疗联合平阳霉素组的副作用更为常见。
