FIGURE 4.4 Common wart injection.

AFTERCARE

• None needed.
  
• Instruct the patient to expect these local symptoms following injection as the immune system is reacting to the antigen: localized erythema, itching, drying of the wart, lesion turning a black color, peeling of the treated tissue, or simply spontaneous regression.
  
• Adverse reactions may also include rash, adenopathy, and persistence of wart(s).
  
• Consider follow-up examination in 2 to 4 weeks.

CPT code: Intralesional injections—11900 (one to seven lesions) and 11901 (greater than seven lesions)

PEARLS

• Candida antigen should not be used after a previous unacceptable adverse reaction such as extreme hypersensitivity or allergy to this antigen or to a similar product.
  
• Repeat injection in 1 month if there is any residual wart.
  
• Sixty-five to seventy-five percent of warts treated with Candida antigen injection resolve after the first injection.
  
• Fifty percent of the remaining warts respond after a second injection.
  
• Antigen injection of warts is an “off-label” use of Candida
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