The efficacy and safety of topical Tretinoin combined with superficial X-ray therapy (SXRT) in treating periungual warts

There are multiple treatment modalities for periungual warts (PWs), although most are destructive and painful, limiting their application. Radiotherapy is a non-invasive method suitable for treating PW patients with contraindications to invasive procedures. To investigate the efficacy and safety of topical Tretinoin combined with Superficial X-ray therapy (SXRT) in treating PWs. This study included patients with 65 PWs who underwent treatment and a 3-month follow-up. Twenty four PWs were subjected to SXRT alone (group A). The remaining 41 PWs were subjected to SXRT combined with the application of the Tretinoin cream from the first day (group B). The overall clinical response rate, recurrence rates, cosmetic outcomes, and adverse events were observed during the follow-up period. The complete clearance rate (75% vs. 92.7% in groups A and B, respectively) and healing times (19.9 vs. 16.0 days in groups A and B, respectively) between the two groups were significantly different (p < 0.046 and 0.04), indicating the combination treatment is more effective. Notably, there was no damaging or permanent deformation on the nail, and the other adverse effects were mild and bearable. Topical Tretinoin combined with SXRT therapy is an effective strategy for treating PWs, with minor side effects. It is painless and with excellent cosmetic outcomes.