How would you treat disseminated flat warts in an immunosuppressed patient with skin of color?

Hard to imagine Imiquimod working in a dry wart. Thinking back to the genital studies... only the occluded (moist) warts responded.

I generally try to curette them over several visits.

Compounded cidofovir (off-label, etc.) might be the best bet.

Imiquimod