A Novel Triple Combination Therapy for the Treatment of Recalcitrant Plantar Warts: A Case Report

Recalcitrant plantar warts, caused by human papillomavirus, often resist conventional treatments, necessitating alternative approaches. This case report details the successful treatment of a persistent plantar wart in a 24-year-old male using a novel triple combination therapy. The patient had previously undergone multiple unsuccessful treatments, including cryotherapy, salicylic acid, and duct tape occlusion. The combination therapy consisted of cryotherapy, topical imiquimod 5% cream, and intralesional injections of purified protein derivative (PPD). The regimen was administered over six weeks, with cryotherapy and PPD injections every three weeks, and imiquimod applied every other day. Significant regression was observed by the second session, with near-complete resolution by the third. At six-month follow-up, no recurrence was noted, and the skin had healed without scarring. This case highlights the synergistic effects of combining physical destruction (cryotherapy), immune modulation (imiquimod), and local immune stimulation (PPD) to successfully treat recalcitrant plantar warts. This triple combination therapy may offer a promising option for cases unresponsive to standard treatments, providing a comprehensive approach that reduces recurrence and promotes complete resolution.