Treatment of recalcitrant periungual warts with cimetidine in pediatrics

Viral warts, caused by human papilloma virus (HPV), are commonly seen in dermatology clinics. However, treatment for warts can be challenging, and there is no single method of treatment that is universally effective. Conventional therapies involve the physical destruction of lesions, including cryotherapy, electrodesiccation, CO2 laser, and topical keratolytic agents. Successful treatment of recalcitrant warts, especially periungual lesions and verruca plana of the face, had been limited with the conventional modalities. These painful procedures resulting in poor compliance, cosmetic disfiguration, and residual indolent lesions usually led to incomplete treatment. Use of high-dose cimetidine in the treatment of viral warts has been reported in the literature in recent years; however, with conflicting results. Herein, we present a 12-year-old girl with recalcitrant periungual warts, successfully treated with cimetidine for 4 months without subsequent recurrence and side effects.