Successful Treatment in a Child with Refractory Periungual Warts by Local Hyperthermia: A Case Report

Abstract

Periungual wart is a kind of verruca vulgaris that occurs alongside or underlying the nails, which is challenging to treat and prone to recurrence, seriously affecting the quality of patients' life. We report a 6-year-old boy with periungual warts who had experienced various treatments with no improvement and even worsening. Therefore, we tried to treat the patient with local hyperthermia which uses a patented device that has an infrared emission source. The heat generated by infrared rays acts on the local skin surface. The mechanism of this therapy may be to establish a specific immune response against human papillomavirus-infected tissues, thereby facilitating the clearance of human papillomavirus at irradiated and non-irradiated sites. Local hyperthermia has the advantages of non-contact, safety, noninvasive, less pain, and so on. After 5 treatments, the irradiated periungual warts completely cleared after 2 weeks. The unirradiated sites were almost cured after 7 weeks. This case suggests that local thermotherapy has shown great advantages in the treatment of these refractory periungual warts and offers a new and effective therapy in patients with periungual warts.

Keywords: child; local hyperthermia; periungual warts; refractory warts.

Figure 1

Before this visit, the child’s nails had become red, oozing, and blistered due to topical chlorhexidine acetate. (A and B).

Figure 2

Treatment of periungual warts in the patient with local hyperthermia. (A and B) Warts around the nails, under the nails, and on the fingers before treatments (red circle indicates irradiated target lesion) (C and D) After 10 treatments, almost all warts disappeared, and nails were almost back to normal condition.