Isolated limb infusion as a novel treatment for extensive plantar warts

We describe the previously unreported use of isolated limb infusion (ILI) to treat extensive, bilateral plantar warts in a 54-year-old female. The warts had covered the weight-bearing surfaces of both feet for 10 years and had failed to respond to all previous treatments.

A standard ILI technique was used to infuse melphalan and actinomycin D to the left leg. Circulation was maintained for 30 min. The limb was warmed and upon completion of the procedure was markedly hypoxic and acidotic. The contralateral limb was treated 6 months later.

At 5 weeks, a partial response with 80% disease clearance was observed. Pain impeded mobilisation until desquamation occurred 6 weeks postoperatively. There was little regrowth at 6 months.

Although invasive, ILI may represent a viable treatment option for resistant human papilloma virus-induced warts on the peripheries. Further research into this potential treatment tool is warranted.