Persistent Periungual Warts in a 39-Year-Old Male: Ongoing Management with Candida Antigen and Cryotherapy

by: Ashley Baldree


Village Dermatology – Katy & Houston, Texas

A 39-year-old male returned to our clinic for follow-up treatment of multiple warts located on the left dorsal thumb metacarpophalangeal joint and periungual skin of both the left thumb and left index finger. The patient was last evaluated on June 26, 2025, when the lesions were treated with Candida antigen injections and liquid nitrogen cryotherapy.

History and Patient Experience

The patient reported slow but noticeable improvement following prior treatments. While alternative options, such as bleomycin injections or cauterization, were discussed, he preferred to continue with the current regimen and reassess progress at the next visit.

Examination Findings

On examination, three wart lesions remained present—thickened, hyperkeratotic, and located near the nail folds and dorsal thumb joint. These periungual warts are particularly challenging due to their proximity to the nail matrix and higher recurrence rates.

Diagnosis

  • Verruca Vulgaris (Common Warts) – periungual and dorsal thumb joint

  • Contagious viral skin lesions caused by human papillomavirus (HPV)

  • Associated mild inflammation and skin irritation

Treatment Plan

The patient underwent a sixth treatment session, which included:

  • Candida antigen injections to stimulate a localized immune response against HPV

  • Cryotherapy with liquid nitrogen to destroy wart tissue

These procedures are performed because untreated periungual warts can enlarge, cause pain, spread to other areas, and lead to nail dystrophy.

The patient was counseled on:

  • Avoiding direct contact with the lesions to reduce transmission

  • Expected treatment course—warts may require multiple sessions over several months

  • Possible side effects including blistering, pigment changes, or incomplete clearance

Follow-up is scheduled in 4 weeks to monitor progress and consider additional options if improvement stalls.

Why Treating Periungual Warts Early Matters

Periungual warts can be more than a cosmetic concern—they can damage the nail structure and spread to surrounding skin. Early treatment increases the chance of complete resolution and helps prevent complications.

If you live in Katy or Houston, Texas and have stubborn or recurring warts, Village Dermatology offers targeted, evidence-based treatments including cryotherapy, immunotherapy, and advanced removal techniques.

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Managing Molluscum Contagiosum: A 43-Year-Old Male with Axillary Rash