Efficacy of oral zinc sulphate versus cryotherapy in the treatment of palmoplantar warts
DOI:
https://doi.org/10.66344/jpad.v31i4.1718Abstract
Objective To compare the efficacy of oral zinc sulphate versus cryotherapy in treatment of palmoplantar warts.
Methods This randomized control trial was conducted in Department of Dermatology Nishtar Hospital Multan for a period of 6 months. A total of 104 patients having palmoplantar warts of less than 3 months, 18-35 years of age and both genders were included. Patients with periungal warts and pregnancy were excluded. Patients were randomly allocated into two groups by lottery method. Group A patients were given oral zinc sulphate (10mg/kg/day) into two divided doses for 6 weeks. Group B patients were given cryotherapy at weekly intervals for maximum of 6 sessions. Patients were followed at 2nd, 3rd and 6th week. At the end of 6 weeks both the groups were evaluated for treatment efficacy.
Results The mean age of patients in group A was 24.58±5.32 years and in group B was 24.13±5.40 years. Out of 104 patients, 56 (53.85%) were females and 48 (48.15%) were males with female to male ratio of 1.2:1. Efficacy of Group A (oral zinc sulphate) was seen in 45 (86.54%) patients while in Group B (cryotherapy) was seen in 33 (63.46%) patients (p-value = 0.007).
Conclusion Oral zinc sulphate has more efficacy than cryotherapy in the treatment of palmoplantar wart.
References
1. Sterling J. Viral infections. In: Burns T, Breathnach S, Cox N, Griffiths C. Rook’s Text book of Dermatology. 8th ed. UK: Wiley-Blackwell; 2010. p. 33.37-59.
2. Androphy EJ, Kirnbauer R. Human papillomavirus infections. In: Goldsmith LA, Katz SI, Golchrest BA, Paller AS, Wolff K. editors. Fitzpatrick’s Dermatology in general medicine. 8th ed. New York: McGraw-Hill; 2012. p. 2421-33.
3. Sterling JC, Gibbs S, Hussain HS, Mustapa MF, Jones HE. British Association of Dermatologists’ guidelines for the management of cutaneous warts 2014. Br J Dermatol.2014;171(4):696-712.
4. Rivera A, Tyring SK. Therapy of cutaneous human Papillomavirus infections. Dermatol Ther.2004;17:441-8.
5. Bellew SG, Quartarolo N, Janniger CK. Childhood warts: an update. Cutis.2004; 73:379-84.
6. Silverberg NB. Human papillomavirus infections in children. Curr Opin Pediatr. 2004;16:402-409.
7. Bruqqink SC, Gussekloo J, Berger MY, Zaaijer K, Assendelft WI, de Waal MW, et al. Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care. Randomised controlled trial. J Can Med Assoc.2010;182(15):1624-30.
8. Dhar SB, Rashid MM, Islam A, Bhuiyan M. Intralesional bleomycin in the treatment of cutaneous warts: a randomized clinical trial comparing it with cryotherapy. Indian J Dermatol Venerol Leprol. 2009;75(3):262-7.
9. Focht DR, Spicer C, Fairchok MP. Efficacy of duct tape versus cryotherapy in the treatment of verruca vulgaris. Arch Pediatr Adolesc Med.2002;156(10):971-4.
10. Kitamura H, Morikawa H, Kamon H, Iguchi M, Hojyo S, Fukada T, et al. Toll-like receptor-mediated regulation of zinc homeostasis influences dendritic cell function. Nat Immunol.2006;7:971–7.
11. Ibs KH, Rink L. Zinc-altered immune function. J Nutr.2003;133(1):1452S–6S.
12. Fraker PJ, King LE. Reprogramming of the immune system during zinc deficiency. Annu Rev Nutr.2004;24:277–98.
13. Sterling JC, Handfield-Jones S, Hudson PM; British Association of Dermatologists. Guidelines for the management of cutaneous warts. Br J Dermatol.2001;144:4–11.
14. Riaz A, Riaz J, Ahmed W, Mushtaq R, Riaz O, Mushtaq K. Comparison of efficacy of cryotherapy versus oral Zinc sulphate in the treatment of cutaneous warts. PAFMJ.2020; 70(2):519-23.
15. Al-Gurairi FT, Al-Waiz M, Sharquie KE. Oral zinc sulphate in the treatment of recalcitrant viral warts: Randomized placebo-controlled clinical trial. Br J Dermatol.2002;146:423–31.
16. Sadighha A. Oral zinc sulphate in recalcitrant multiple viral warts: A pilot study. J Eur Acad Dermatol Venereol. 2009;23:715–6.
17. López-Garcia DR, Gómez-Flores M, Arce-Mendoza AY, de la Fuente-Garcia A, Ocampo-Candiani J. Oral zinc sulphate for unresponsive cutaneous viral warts: Too good to be true? A double blind, randomized, placebo-controlled trial. Clin Exp Dermatol.2009;34:e984–5.
18. Stefani M, Bottino G, Fontenelle E, Azulay DR. Efficacy comparison between cimetidine and zinc sulphate in the treatment of multiple and recalcitrant warts. An Bras Dermatol.2009;84:23–9.
19. Bigby M, Gibbs S, Harvey I, Sterling J. Warts. Clin Evid.2004;11:2209–2223.
20. Buckley D. Cryosurgery treatment of plantar warts. Ir Med J.2000;93:140–3.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Sumreen Hafeez, Leena Hafeez, Javaid Iqbal
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
