Comparison of efficacy of 30% solution of trichloroacetic acid (TCA) with 0.025 % tretinoin in the treatment of flat warts at a tertiary care hospital

Abstract

Abstract: Background Warts are common epidermal growths caused by human papillomavirus that often cause significant discomfort and embarrassment.  Objective To compare the efficacy of 30 % solution of trichloroacetic acid(TCA) with 0.025 % tretinoin in the treatment of flat warts. Methods This randomized controlled trial was conducted in department of dermatology, Nishtar Hospital Multan for a period of 6 months. A total of sixty patients meeting the inclusion criteria were randomly allocated in to two groups by lottery method. Group A, having 30 patients received 30% TCA topical application once weekly by the physician. In group B, 30 patients were asked to apply 0.025 % tretinoin lotion, twice daily. The patients were followed up every 2 weeks for 12 weeks. Efficacy was noted at the end of 12 weeks. Results Our study comprised of a total of 60 patients meeting inclusion criteria. Of these 60 study cases, 37 (61.7 %) were male patients while 23 (38.3 %) were female patients. Mean age of our study cases was 26.00 ± 7.53 years . Of these 60 study cases, 21 (35.0 %) belonged to rural areas and 39 (65.0 %) belonged to urban areas.  Monthly family income up to Rs. 30000 was noted in 25 (41.7%) and more than Rs. 30000 was noted in 35 (58.3%). Mean body mass index of our study cases was 25.23 ± 2.18 kg/m2 and obesity was present in 10 (16.7 %) of our study cases. Mean no. of lesions was 7.23 ± 2.89 and 51 (85.0%) patients had up to 10 lesions. Mean disease duration was 1.92 ± 0.85 months and 44 (73.3%) had duration of illness more than 1.5 months. Of these 60 study cases, 39 (65 %) had lesions on face and 21 (35 %) had lesions on the back of hand. Efficacy was noted in 43 (71.7%), in group A efficacy was noted in 27 (90%) while in group B, efficacy was 16 (53.3%) Conclusion Efficacy of 30 % TCA was significantly higher as compared with 0.025% tretinoin. So, we support the use of 30% TCA in the treatment of flat warts in comparison with 0.025% tretinoin. Keywords Flat warts, Trichloroacetic acid, tretinoin, efficacy.