The Painful Purple Digit: An Alarming Complication of Candida albicans Antigen Treatment of Recalcitrant Warts

Marissa Perman; J. Barton Sterling; Anthony Gaspari

Dermatitis. 2005;16(1):38-40.

Abstract and Introduction

Candida albicans ( CA ) antigen immunotherapy for recalcitrant warts is a novel treatment that has had much success in the recent past. Although several side effects are well documented in the literature, we report a new adverse reaction to CA antigen immunotherapy for verruca vulgaris of the distal fingertip. Our patient received an intradermal injection of CA antigen solution into periungual warts located on the distal left thumb and distal subungual area of the left index finger. Within 24 hours, the patient reported pain, edema, and a purple hue to only the index finger. Incision of the finger demonstrated no hematoma or compartment syndrome. Although the etiology is unknown, we believe the condition was most likely due to edema and vascular compromise secondary to a vigorous delayed-type hypersensitivity reaction, possibly leading to cyanosis of the distal index finger. We report this case to make physicians who use intralesional CA antigen aware of a new possible complication at this anatomic location.

The use of immunotherapy to treat human papillomavirus (HPV) infection is currently on the rise. We describe a complication of Candida albicans (CA) antigen treatment of verruca vulgaris in the subungual area of the distal fingertip.

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Cite this: The Painful Purple Digit: An Alarming Complication of Candida albicans Antigen Treatment of Recalcitrant Warts - Medscape - Mar 01, 2005.

Abstract and Introduction
Case Report
Discussion
References

Clinical Features of Compartment Syndrome in Case Report Patient
Signs/Symptoms	Patient with Compartment Syndrome	Our Patient
Pain out of proportion to injury	Yes	Yes
Paresthesias in distribution of nerve passing through compartment in question	Yes	Not formally assessed
Pain on passive stretch of muscle within compartment	Yes	Yes
Tenseness of compartment on palpation	Yes	Yes
Weakness of muscles within compartment	Yes	Unable to assess because of severe pain

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