to the editor: I enjoyed the article on nail disorders.1 The authors state that periungual warts are difficult to treat due to their proximity to the nail bed growth plate. The use of harsh chemicals, electrosurgery or cryosurgery may disrupt nail growth permanently.
For the past decade or so I have been using a technique about which I read many years ago in Cutis.2 The author suggested treating these warts by occlusion using ordinary white adhesive tape (the old-fashioned type, now used mostly for ankle taping). A large part of therapy is the psychologic component. The author used an ordinary roll of tape, but labeled it “WART TAPE.” This was wrapped around the finger with much ceremony. The tape is to be left on for six days, removed on a set day of the week (I usually choose Sunday), then replaced the next morning. After four weeks I've seen about an 80 percent cure rate.
You can have the patient return to the office for each re-taping or simply have the patient or parent do it at home. The cost is minimal, other than the office visit, and the therapy is essentially risk-free; there is no real damage to the nail bed matrix.