BI30 Remission of a large plantar verruca vulgaris in an immunocompromised patient postincisional punch biopsy

Abstract We report the case of a 41-year-old renal transplant recipient who has been attending dermatology for skin surveillance following cadaveric transplant. His immunosuppressive treatment consists tacrolimus, mycophenolate mofetil and prednisolone 5 mg once daily. primary dermatological complaint was that large wart on plantar aspect his right foot. Given location this lesion, there significant associated pain, which also resulted in functional impediment, impacting ability to exercise or work. On examination, he had large, hyperkeratotic, papillomatous nodule measuring 3.5 × 3 cm foot, clinically keeping with verruca vulgaris. This recalcitrant extensive treatment, including topical salicylic acid, 5-fluorouracil, cantharidin numerous courses cryotherapy paring over previous 6 years. Following administration xylocaine 1% adrenaline as local anaesthetic, we performed three incisional 4-mm punch biopsies through centre depth dermis. ensured visualization haemorrhage at base each incision. The biopsy cores were left situ wound dressed petroleum jelly, Kaltostat® Opsite. At 6-week follow-up review, vulgaris completely resolved. No postprocedural complications noted by patient. Further scheduled months later, time no recurrence occurred. Verruca is benign proliferation epidermal cells driven human papillomavirus (HPV) infection, commonly acquired childhood. For many patients, will spontaneously regress. However, it can represent therapeutic challenge when persistent, multiple modalities, particularly immunosuppressed patients. To our knowledge, first documented resolution giant an immunocompromised patient using such approach. Renal patients unique cohort relation vulgaris, whereby impaired cell-mediated immunity increase their susceptibility HPV, thereby reducing effective options meaning definitive clearance may never be achieved. Our highlights accessible cost-effective approach where alternative would necessitate hospital visits.