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Periungual and subungual warts successfully treated with combination of electric shaving, curettage, and photodynamic therapy

Periungual and subungual warts are difficult to treat because of their special location. Combination of electric shaving, curettage, and photodynamic therapy (PDT) is effective. Electric shaving could expose warts completely and provide convenience for treating lesions under the toenail. Curettage removes warts to do a biopsy confirming the diagnosis and promotes photosensitizer penetration in pretreatment of PDT. Meanwhile, PDT selectively destroys warts in the epidermis without damaging dermis. Here, we present a case of periungual and subungual warts successfully treated by combination of electric shaving, curettage, and PDT. It should be noticed that pathological diagnosis is necessary for this case, because it could help differentially diagnosing with non-pigmented malignant melanoma and early acral verrucous carcinoma.