Recalcitrant viral warts treated by diphencyprone immunotherapy

Recalcitrant viral warts are a troublesome therapeutic problem. Immunothera py with the universal allergic contact sensitizer diphencyprone (DCP) has b een used successfully in such cases, We have reviewed our experience of the use of DCP in the treatment of resistant hand and foot warts during an 8-y ear period. Sixty patients were sensitized to DCP during this time; the med ian duration of warts was 3 years. Twelve patients defaulted from treatment . Of the remaining 48 individuals, 42 (88%) cleared of all warts. The media n number of treatments to clear was five (range one to 22) and the median t ime to clear was 5 months (range 0.5-14). Adverse effects occurred in 27 of 48 patients (56%), most commonly painful local blistering (n = 11), bliste ring at the sensitization site (n = 3), pompholyx-like reactions (n = 7) an d eczematous eruptions (n = 4), Three of those who defaulted did so due to side-effects, one became pregnant and eight dropped out for unknown reasons . Three of the 48 patients who cleared or had at least six treatments also discontinued DCP therapy due to side-effects, but most tolerated treatment well. Twenty-five patients were followed up for periods of 1 month to 8 yea rs (median 2 years) and none had a recurrence, DCP immunotherapy is an effe ctive option for the treatment of recalcitrant viral warts but patients mus t be motivated to attend for sequential applications and must be warned abo ut potential uncomfortable side-effects.