Radiation and Hyperthermia Combination Therapy for Recalcitrant Verruca Vulgaris.

A 47-year-old white woman presented to our clinic complaining of recalcitrant warts on her trunk and extremities. She had an extensive past medical history including immunodeficiency of unknown origin, pulmonary hypertension, rheumatoid arthritis, and systemic lupus erythematosus, for which she was being treated with chronic immunosuppressive therapy with methylprednisolone and belimumab. The patient had previously failed treatments at an outside facility with liquid nitrogen, trichloroacetic acid, topical cidofovir, imiquimod, topical 5-fluorouracil, intralesional candida antigen, pulsed-dye laser (Vbeam Perfecta), surgical excision, and photodynamic therapy. (SKINmed. 2019;17:68-71).

Cutaneous reactions to recombinant cytokine therapy

Cytokines are critical to several fundamental homeostatic mechanisms such as fever, acute phase reactions, wound healing, hematopoiesis, inflammation, cellular and humoral immune responses, and tumor regression. As a result of advances in recombinant DNA technology, recombinant cytokines are available as therapeutic agents. They have been used for metastatic cancers and immunodeficiencies, as a therapy for naturally occurring or drug-induced anemias or leukopenias, and they have also been applied to some cutaneous disorders. Cytokine therapy can result in toxic reactions that affect many organ systems, especially the skin. These reactions are common and diverse, ranging from minor injection site reactions, pruritus, and flushing to life-threatening autoimmune disorders, severe erythroderma, or bullous skin reactions. This review focuses on the major cytokines that are in current clinical use or under investigation and describes the cutaneous complications of these agents.