Intralesional purified protein derivative (PPD) and intralesional Candida antigen have shown promising efficacy in the treatment of different types of warts; however, a combination of both has not been previously used.1 In this study we compared the efficacy and safety of combined intralesional PPD and intralesional Candida antigen, in an alternating manner, vs either agent alone in the treatment of common warts. The study included 160 patients of different age groups presenting with multiple common warts. Patients were randomly assigned to 4 groups of 40 patients each. Group 1 received 0.1 mL of intralesional PPD. Group 2 received 0.1 mL of a 1/1000 solution of Candida antigen. Group 3 received an alternating therapy of intralesional PPD and intralesional Candida antigen. Group 4 received 0.1 mL of intralesional saline (control group). In all the groups, intralesional injections were done into the largest wart at 2-week intervals until complete clearance was achieved or for a maximum of 6 sessions. Written informed consent was taken from each patient before enrollment into the study that had been approved by the Zagazig University Institutional Review Board. There were 143 patients who completed the study, and 17 patients discontinued at different times for different causes. Complete clearance of warts was observed in 22 patients (61.1%) of the PPD group, in 14 patients (36.8%) of the Candida antigen group, in 24 patients (70.6%) of the alternating therapy group (Fig 1), and in 3 patients (8.6%) of the saline control group. The difference in the therapeutic response between the alternating therapy group and the other groups was statistically significant (Table I). It is worthy of note that in populations without widespread immunity to Bacillus Calmette–Guérin, similar response rates using PPD may not be observed. Therefore, selection of the appropriate population and the proper antigen is crucial in the field of intralesional antigen immunotherapy.