CASE PRESENTATION
In September 2021, a 69-year-old man was admitted into our department
with hand warts (Figure 1). Diagnosis was performed by clinical
observation. The fingertip of the right thumb showed soft tissue defect
with warts extending to the finger stump. The patient reported that this
finger was normal prior to wart occurrence. The thumb of the left hand
also presented periungual warts, which caused nail damage. The patient
reported the existence of pimples in this finger for more than 10 years,
and which started to worsen during the past 4 years. The patient further
reported that he had not performed any previous treatment and family
history, due to his function as a caregiver to a colon colostomy
patient, which made him manage the excrement from the fistula. The
patient reported no physical discomfort except itching. However, such
lesions had a psychological impact, as the patient reported to feel
shame in showing his hands and was afraid that he could infect others.
The patient reported no additional diseases.
Our previous study showed that Superficial X-Ray Therapy (SXRT. SRT-100,
Sensus Healthcare, Boca Raton, Florida) combined with Tretinoin is
effective for periungual warts3. Therefore, we made
the decision to use SXRT combined with Tretinoin to treat our patient.
We administered a 5 Gy fraction per week, up to a total dose of 20 Gy.
Tretinoin cream (Med-Xine Pharmaceutical Co. LTD, Sichuan, China) was
evenly smeared and the lesion was subsequently wrapped with saran for 8
hours a day during 20 days from the first fraction of radiotherapy. The
compliance of patient was good. The warts began to shed after three
fractions and were completely removed 26 days after treatment completion
(Figures 2,3). The patient showed mild pruritus. No recurrence was
observed after one year follow-up.