Efficacy of intralesional vitamin D3 in cutaneous warts
Keywords:
Plantar warts, Cutaneous warts, Intralesional treatment, Vitamin D3, EfficacyAbstract
Objective: The objective of this study was to determine the efficacy of intralesional vitamin D3 in cutaneous warts Study Design: Descriptive Case Series Study Place and Duration of Study: Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi from August 2018 to February 2019. Methodology: The study comprised 226 patients with palmoplantar warts of various sizes and duration. After injecting lignocaine with 0.2 ml (20 mg/ml), about 0.5 mL of vitamin D3 solution (200,000 IU, 15 mg/mL) was administered to the base of the warts. At 2-week intervals, up to 5 warts might be injected every session until they disappeared, which could take up to 4 treatments. Following the final injection, patients were monitored for 6 months to look for any recurrence. Results: The study was completed by 226 patients. The average number of injections needed to obtain a complete resolution was 2.93+0.60. Complete response was observed in 185 (81.9%) patients. Conclusion: Cutaneous warts can be treated effectively, affordably, and safely with intralesional vitamin D3. Keywords: Plantar Warts, Cutaneous Warts, Intralesional Treatment, Vitamin D3, Efficacy.References
Sterling JC, Handfield-Jones, Hudson PM. British association of dermatologists. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001;144:4-11.
Gibss S, Harvey I, Sterling J, Stark R. Local treatments for cutaneous warts: systematic review. BMJ. 2002;325:461.
Savant SS, Gore D. Electro surgery. In: Savant SS, Shah RA, Gore D, editors. Textbook and Atlas of Dermatosurgery and Cosmetology. Mumbai: ASCAD; 2005. P. 305-14.
Bourke JF, Berth-Jones J, Hutchinson PE. Cryotherapy of common viral warts at intervals of 1, 2 and 3 weeks. Br J Dermatol. 1995;132:433-6.
Tan OT, Hurwitz RM, Stafford TJ. Pulsed dye laser treatment of recalcitrant verrucae: a preliminary report. Lasers Surg Med. 1993;13:127-37
Nofal A, Nofal E. Intralesional immunotherapy of common warts: Successful treatment with mumps, measles and rubella vaccine. J Eur Acad Dermatol Venereol. 2010;24:1166- 70.
Shaheen MA, Saleem SA, Fouad DA, El-Fatah AA. Intralesional tuberculin (PPD) versus measles, mumps, rubella (MMR) vaccine in treatment of multiple warts: a comparative clinical and immunological study. Dermatol Ther. 2015;28:194-200.
Garg S, Baveja S. Intralesional immunotherapy for difficult to treat warts with Mycobacterium w vaccine. J Cutan Aesthet Surg. 2014;7:203-8.
Majid I, Imran S. Immunotherapy with intralesional Candida albicans antigen in resistant or recurrent warts: a study. Indian J Dermatol. 2013;58:360-5.
Bhutto AM, Shah AH, Ahuja DK, Solangi AH, Shah SA. Pattern of sexually transmitted infections in males in interior Sindh. A 10 year study. J Ayub Med Coll Abbott. 2011;23(3):110-4.
Rind T, Oiso N, Kawada A. Successful treatment of anogenital wart with a topical Vitamin D(3) derivative in an infant. Case Rep Dermatol. 2010;2:46-9.
Imagawa I, Suzuki H. successful treatment of refractory warts with topical Vitamin D3 derivative (maxacalcitol, 1alpha, 25-dihydroxy-22-oxacalcitriol) in 17 patients. J Dermatol. 2007;34:264-6.
AlGhamdi K, Kumar A, Moussa N. The role of vitamin D in melanogenesis with an emphasis on vitiligo. Indian J Dermatol Venereol Leprol. 2013;79:750-8.
Aktas H, Ergin C, Demir B, Ekiz O. Intralesional vitamin D injection may be an effective treatment option for warts. J Cutan Med Surg. 2016;20:118-22.
Leung L. Treating common warts - options and evidence. Aust Fam Physician 2010;39:933-7.
Loo SKF, Tang WYM. Warts (non-genital). BMJ Clin Evid 2009;2009:1710.
Bhutto AM, Shah AH, Ahuja DK, Solangi AH, Shah SA. Pattern of sexually transmitted infections in males in interior Sindh: a 10-year-study. J Ayub Med Coll Abbott 2011;23:110-4.
Namburi URS, Omprakash, Babu G. A review on management of warts in Ayurveda. Ayu 2011;32:100-2.
Hannuksela M. Treatment of common warts. Duodecim 2012;128:1797-802.
Aktas H, Ergin C, Demir B, Ekiz O. Intralesional Vitamin D Injection May Be an Effective Treatment Option for Warts. J Cutan Med Surg 2016;20:118-22.
Dall'oglio F, D'Amico V, Nasca MR, Micali G. Treatment of cutaneous warts: an evidence-based review. Am J Clin Dermatol 2012;13:73-96.
Das S, Chowdhury J, Patra S, Ghoshal L, Banerjee S. Auto-wart inoculation: An easy and effective treatment of multiple, recalcitrant and genital warts. J Pak Assoc Dermatol 2017;26:229-34.
Gupta R. Plantar warts treated with topical adapalene. Indian J Dermatol 2011;56:513-4.
Gharib IEl, Aly DG, Emam HM, Khater OH. Evaluation of acitretin in the treatment of multiple recalcitrant common warts: a pilot study. Pigment Dis 2015;2:183-7.
Miller J, Gallo RL. Vitamin D and innate immunity. Dermatol Ther 2010;23:13-22.
Uyar B, Sacar H. Comparison of cryotherapy session intervals in the treatment of external genital warts. Dermatologica Sinica 2014;32:154-6.
Lal NR, Sil A, Gayen T, Bandyopadhyay D, Das NK. Safety and effectiveness of autoinoculation therapy in cutaneous warts: a double--blind, randomized, placebo-controlled study. Indian J Dermatol Venereol Leprol 2014;80:515-20.
Syed TA, Hadi SM, Qureshi ZA, Ali SM, Kwah MS. Treatment of external genital warts in men with imiquimod 2% in cream. A placebo-controlled, double-blind study. J Infect 2000;41:148-51
