What is the maximum amount of bleomycin that should be injected for the treatment of verrucae (warts)?

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From the Research

The maximum recommended dose of bleomycin for wart treatment is up to 3 mL per session, with a concentration of 1.5 U/mL, as supported by the study published in 2006 1. This dose can be administered in multiple injections, with the total dose depending on the size of the lesion.

  • The dose ranged from 0.25 to 1.0 mL per injection per lesion in the study 1.
  • Treatment sessions should be spaced according to the clinical response, with most patients requiring one or two injections for complete resolution, as shown in the study 1.
  • Bleomycin should be injected directly into the wart using a suitable needle until blanching occurs.
  • This treatment is typically reserved for recalcitrant warts that have failed other therapies.
  • Bleomycin works by causing DNA damage and inducing apoptosis in infected cells, effectively destroying the wart tissue.
  • Side effects include pain during injection, local necrosis, and potential nail changes when used for periungual warts.
  • A more recent study published in 2021 2 used a concentration of 1 mg/ml, but the study from 2006 1 provides a clearer guideline for the maximum dose.
  • Other studies, such as those published in 1986 3, 1980 4, and 2014 5, provide additional information on the treatment of warts, but the study from 2006 1 is the most relevant to the question of maximum dose.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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