Intralesional bleomycin in cutaneous warts: Does combining with lasers or electroporation confer additional benefit?

To the Editor: Intralesional bleomycin in combination with pulsed dye laser (PDL) and electroporation has been described in the treatment of warts.1-4 The rationale for combining these modalities with intralesional bleomycin is to enhance bleomycin infiltration into the wart. However, whether these combinations impart additional benefit over intralesional bleomycin alone is uncertain. We searched PubMed and Embase from database inception to June 1, 2020 for interventional studies, published in English, that evaluated bleomycin in combination with lasers or electrochemotherapy.