• 1

    Johnson SM, Roberson PK, Horn TD: Intralesional injection of mumps or Candida skin test antigens: a novel immunotherapy for warts. Arch Dermatol 137: 451, 2001.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Johnson S, Roberson P, Horn T: Intralesional immunotherapy of warts with mumps, candida, and Trichophyton skin test antigens. Arch Dermatol 141: 589, 2005.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Kwok CS, Gibbs S, Bennett C, et al: Topical treatments for cutaneous warts. Cochrane Database Syst Rev 9: CD001781, 2012.

    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 4

    Bunney MH, Nolan MW, Williams DA: An assessment of methods of treating viral warts by comparative treatment trials based on a standard design. Br J Dermatol 94: 667, 1976.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Johnson S, Horn T: Intralesional immunotherapy for warts using a combination of skin test antigens: a safe and effective therapy. J Drugs Dermatol 3: 263, 2004.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Clifton MM, Johnson SM, Roberson PK, et al: Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens. Pediatr Dermatol 20: 268, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7

    Bacelieri R, Johnson SM: Cutaneous warts: an evidence-based approach to therapy. Am Fam Physician 72: 647, 2005.

  • 8

    Clemons RJ, Clemons-Miller A, Johnson SM, et al: Comparing therapy costs for physician treatment of warts. J Drugs Dermatol 2: 649, 2003.

  • 9

    Leung L: Hyfrecation for recalcitrant nongenital warts. J Family Med Prim Care 2: 141, 2013.

  • 10

    Kim KH, Horn TD, Pharis J, et al: Phase 1 clinical trial of intralesional injection of Candida antigen for the treatment of warts. Arch Dermatol 146; 12. 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 11

    Brunk D: Injection of Candida antigen works on warts. Skin Allergy News 30: 5, 1999.

  • 12

    Signore RJ: Candida albicans intralesional injection immunotherapy of warts. Cutis 70: 185, 2002.

  • 13

    Phillips RC, Ruhl TS, Pfenninger JL, et al: Treatment of warts with Candida antigen injection. Arch Dermatol 136: 1274, 2000.

  • 14

    Maronn M, Salm C, Lyon V, et al: One year experience with Candida antigen immunotherapy for warts and molluscum. Pediatr Dermatol 25: 189, 2008.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 15

    Majid I, Imran S: Immunotherapy with intralesional Candida albicans antigen in resistant or recurrant warts: a study. Indian J Dermatol 58: 360, 2013.

  • 16

    Perman M, Sterling JB, Gaspari A: The painful purple digit: an alarming complication of Candida albicans antigen treatment of recalcitrant warts. Dermatitis 16: 38, 2005.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Signore RJ: An alarming complication of Candida albicans antigen treatment of recalcitrant warts [letter to the editor]. Dermatitis 16: 216, 2005.

  • 18

    Wilmer EN, Burkhart CN, Morrell DS: Goodbye warts, hello vitiligo: Candida antigen-induced depigmentation. Pediatr Dermatol 30: e214, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation

Candida albicans Immunotherapy for Verrucae Plantaris

Tracey C. Vlahovic Temple University School of Podiatric Medicine, Philadelphia, PA. Dr. Ghosh is now with St. Luke's Hospital, Allentown, PA. Dr. Tran is now with Metrowest Medical Center, Framingham, MA.

Search for other papers by Tracey C. Vlahovic in
Current site
Google Scholar
PubMed
Close
 DPM
,
Samuel Spadone Temple University School of Podiatric Medicine, Philadelphia, PA. Dr. Ghosh is now with St. Luke's Hospital, Allentown, PA. Dr. Tran is now with Metrowest Medical Center, Framingham, MA.

Search for other papers by Samuel Spadone in
Current site
Google Scholar
PubMed
Close
 DPM
,
S. Patrick Dunn Foot and Ankle Clinic of Oakwood Inc, Oakwood, GA.

Search for other papers by S. Patrick Dunn in
Current site
Google Scholar
PubMed
Close
 DPM
,
Tara Fussell Orlando Foot and Ankle Clinic, Orlando, FL.

Search for other papers by Tara Fussell in
Current site
Google Scholar
PubMed
Close
 DPM
,
Ian Hersh Ani Orthopaedic Group of the Orthopaedic & Spine Institute of New Jersey, Hazlet, NJ. Dr. Hersh is now with Foot and Ankle Associates of Florida, Altamonte, FL.

Search for other papers by Ian Hersh in
Current site
Google Scholar
PubMed
Close
 DPM
,
Tyson Green Imperial Health Center for Orthopaedics, Lake Charles, LA.

Search for other papers by Tyson Green in
Current site
Google Scholar
PubMed
Close
 DPM
,
Jeff Merrill Podiatry Department, Skylakes Medical Center, Klamath Falls, OR. Dr. Merrill is now with Klamath Falls Foot and Ankle, LLC, Klamath Falls, OR.

Search for other papers by Jeff Merrill in
Current site
Google Scholar
PubMed
Close
 DPM
,
Payel Ghosh Temple University School of Podiatric Medicine, Philadelphia, PA. Dr. Ghosh is now with St. Luke's Hospital, Allentown, PA. Dr. Tran is now with Metrowest Medical Center, Framingham, MA.

Search for other papers by Payel Ghosh in
Current site
Google Scholar
PubMed
Close
 DPM
, and
Tran Tran Temple University School of Podiatric Medicine, Philadelphia, PA. Dr. Ghosh is now with St. Luke's Hospital, Allentown, PA. Dr. Tran is now with Metrowest Medical Center, Framingham, MA.

Search for other papers by Tran Tran in
Current site
Google Scholar
PubMed
Close
 DPM
Restricted access

Background

Verrucae plantaris is a viral disease caused by human papilloma virus that is commonly seen in the office setting and is often challenging to treat owing to its high recurrence rate and recalcitrant profile. Candida albicans intralesional injections have been hypothesized to incite an immunogenic response toward the virus.

Methods

We report on the immunotherapeutic effect of intralesional injection of C albicans into plantar verrucae with a retrospective medical record analysis of 80 patients. Using a luer-lock syringe, 0.1 to 0.3 mL of C albicans antigen was injected into either the first known lesion or the largest lesion.

Results

The success rate of intralesional C albicans, defined as total clearance of the lesion, was 65%, which may be underestimated because patients lost to follow-up were included in the 35% failure rate. It was also found that female patients with a previous tissue-destructive treatment process were more than four times more likely to respond to C albicans therapy, whereas this effect was less pronounced in the male patient population.

Conclusions

These results indicate that a series of intralesional injections of C albicans is an effective and efficient method of treatment for verrucae plantaris.

Corresponding author: Tracey C. Vlahovic, DPM, Temple University School of Podiatric Medicine, 148 N 8th St, Philadelphia, PA 19107. (E-mail: traceyv@temple.edu)