Successful treatment of disseminated facial verrucae with contact immunotherapy.

Disseminated flat warts are a common therapeutic problem in immunocompromised patients. However, disseminated infection on the face is, even in the immunocompetent host, a challenge. We report on a 14-year-old girl who had suffered from increasing eruptions of multiple disseminated verrucae planae et filiformes of the face for 18 months. As an alternative to silk-touch CO2-laser, contact cryotherapy or systemic immune enhancer we administered topical immunotherapy with diphenylcyclopropenone (DCP). The initial challenge with DCP 2% was performed on the forehead and the challenge was repeated weekly with DCP 0.01%. After four applications, the girl reported peeling of single warts on the forehead but more importantly at distant sites which had not received DCP. After eight weeks the patient's face was free of lesions. So far, the patient has remained free from relapse. This is the first case report of successful topical immunotherapy with DCP in disseminated facial verrucae planae and should be regarded as an effective therapeutic tool in this indication, emphasizing the great advantage of prevention of scarring of the skin induced by other therapeutic modalities.