liquid nitrogen + cantharidin

This is a combination therapy consisting of liquid nitrogen (cryotherapy) and cantharidin, both used topically for the treatment of cutaneous warts, including common and plantar warts. Liquid nitrogen acts as a cryogenic agent that destroys wart tissue by freezing, causing cellular disruption and necrosis. Cantharidin is a vesicant derived from blister beetles; it induces intraepidermal blistering by disrupting desmosomal connections between keratinocytes, leading to controlled epidermal separation and subsequent removal of the wart. The combination may be used sequentially or in tandem to enhance efficacy in recalcitrant or resistant cases where monotherapy has failed[1][3][6]. Both agents are destructive therapies but act via different mechanisms—cryotherapy through rapid freezing/thawing cycles and cantharidin through chemical-induced blister formation.