An Open Randomized Comparative Study of Various Intralesional Immunotherapeutic Agents in Cutaneous Warts

Abstract

INTRODUCTION: Warts or verruca are benign epidermal proliferation of the skin and mucosa, caused by human papilloma virus (HPV). The treatment depends on two main therapeutic options: the first is the conventional destructive method which is painful and associated with scarring and frequent recurrences. Second modality is immunotherapy, which is based on the manipulation of the immune system to achieve a HPV targeted immune reaction.

MATERIAL AND METHOD:  A total of 120 patients attending the Dermatology OPD of our institute, diagnosed as viral warts were enrolled in the study. All patients were assigned individual identification number and were divided randomly into four groups (A, B, C& D) using a table of random numbers. Group A was Injected BCG Vaccine intralesional, Group B was injected MMR Vaccine intralesional, Group C was injected Inj. Vitamin D3 intralesional and Group D was injected Tuberculin purified protein derivative intralesionally, and the result were analyzed.

RESULT: Complete clearance and reduction in numbers of warts on injected and distant are, 76% with BCG vaccine, 45% with MMR vaccine, 55.5% with Inj. Vitamin D3 and 67.8% with Inj. PPD.

DISCUSSION: Local tissue destruction is a commonly employed method in the treatment of warts. However, it is not practical for multiple lesions, palmo-plantar and facial lesions because of associated pain, scarring and pigmentation. In Immunotherapy, warts regressed without any scarring and with minimal recurrence.

CONCLUSION: All the four modality of immunotherapy, which was given intralesional, show positive response and well tolerated therapeutic options for verruca with variable results.