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Bleomycin + 5-fluorouracil refers to a therapeutic approach or comparative study involving the intralesional administration of two distinct cytotoxic agents, bleomycin and 5-fluorouracil (5-FU), primarily for the treatment of plantar warts. Bleomycin is a glycopeptide antibiotic that acts by binding to DNA and inducing single- and double-strand breaks through the generation of free radicals. 5-fluorouracil is a pyrimidine analog antimetabolite that irreversibly inhibits thymidylate synthase, an enzyme essential for DNA synthesis. In clinical practice and research, such as the study conducted by Sohag University (NCT05057663), these agents are injected directly into the wart tissue to induce necrosis of HPV-infected keratinocytes. While often evaluated head-to-head to compare efficacy and safety, they represent two of the most common intralesional treatments for recalcitrant cutaneous warts.
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