The management of vulvovaginal warts using intralesional Bacillus Calmette-Guérin immunotherapy

Genital warts/condyloma acuminata is the most common mucosal human papillomavirus (HPV) infection encountered by the dermatologists. They can be asymptomatic or symptomatic. They can present as discrete lesions or confluent masses. Depending on the HPV strains, lesions can either be benign or may turn malignant. The treatment modalities for genital warts range from topical, systemic, intralesional immunotherapy, and surgical interventions (intralesional immunotherapy has shown promising results in the treatment of viral and genital warts). However, there are very few reports that have used Bacillus Calmette-Guérin (BCG) as immunotherapy in genital warts. Here, we report, in author's opinion, the first case of female vulvovaginal warts successfully treated with intralesional BCG immunotherapy, leading to complete resolution of injected warts as well as near-distant warts.