Needle-free injection of 5-fluorouracil (5-FU) is effective for the treatment of palmoplantar warts, according to a research letter published online on Nov. 29 in the Journal of the American Academy of Dermatology .

Yue Wu, from Zhongda Hospital in Nanjing, China, and colleagues conducted a randomized clinical trial to explore the efficacy and safety of needle-free injection of 5-FU versus cryosurgery therapy for treating palmoplantar warts. Seventy-six patients aged 10 to 75 years with palmoplantar warts were randomly assigned to receive a maximum of three sessions of needle-free injection of 5-FU or cryotherapy every three to four weeks. Patients in the needle-free group received intralesional injections of 5-FU with an injector; a mixture of 5-FU and lidocaine was injected vertically into each wart. Liquid nitrogen was applied with a spray to participants in the cryotherapy group.

The researchers found that 63.16 percent of patients in the needle-free injection group showed complete response (CR), 26.32 percent showed partial response (PR), and 10.53 percent showed no response (NR). In the cryosurgery group, 21.05, 63.16, and 15.79 percent had CR, PR, and NR, respectively. The visual analog scale of the needle-free injection group varied from 1 to 7, with a median of 3, while the median was 6.5 for cryotherapy. Neither group reported serious adverse effects.

"Our study suggested that needle-free injection of 5-FU was a promising therapy, especially for patients who were pain-averse and needle-phobic," the authors write.

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