Title: Treatment of recalcitrant non genital warts with Candida Antigen

Biography:

Lara el Hayderi has completed her PhD at the age of 31 years from Liege University and is currently clinical chief at University of Liege in Belgium. She has published more than 20 papers in reputed journals and has given numerous national and international conferences. She has done clinical research in the field of viral infectious diseases on herpes simplex and varicella zoster virus. She actively gives lectures on cosmetic and dermatology at the University and develops the field.

Abstract

Recurrent resistant non genital warts is a common and disfiguring problem in dermatology. The number of sessions of cryotherapy and CO2 laser may be consequent and are often very painful for our patients during and after the session. The treatment of periungueal warts often results in ungueal dystrophy, sometimes irreversible. Intralesional injection of Candida antigen is a therapeutic alternative and shows good results in term of healing in most cases of non-genital warts resistant to conventional therapies. We followed up a serie of patients treated with Intralesional Candida antigen after unsuccessful treatments by cryotherapy or CO2 laser from January 2018 to June 2019. Up to 80% of patients positively responded to the treatment and healed completely after an average of 4 sessions (3-5 sessions) every 3 weeks at a dose of 0,01 cc/wart. Most patients did not experience any discomfort during the injection or pain after the treatment. Only one patient had a mild case of pain and swell the day of the injection with immediate resolution after NSAI. Few side effects have been described with no serious adverse effects. The compartment syndrome, a painful swell of the treated zone has been described, but no explanation was found regarding this uncommon transitory side effect. Based on the literature, in all cases it resolves within 24-72 hours.

Most of our patients were satisfied with the treatment, however 20% patients did not respond to the Candida antigen treatment after 3 sessions and the treatment was discontinued.

Intralesional injection of Candida antigen to treat non genital warts is an interesting therapeutic option in case of failure of first line therapies such as cryotherapy or CO2 laser. The main advantages of this technique reside in the comfort during and after the treatment with no downtime or scarring.