The outcome of intralesional vitamin D3 (alphacalcidol) injection in treatment of cutaneous warts

Authors

  • Asma Masood Department of Dermatology, Mayo Hospital, Lahore
  • Noshi Ilyas Department of Dermatology, Mayo Hospital, Lahore
  • Saira Riaz Department of Dermatology, Mayo Hospital, Lahore
  • Nehel Raza Department of Dermatology, Mayo Hospital, Lahore
  • Burhan Ashraf Department of Dermatology, Mayo Hospital, Lahore
  • Sara Mubeen Department of Dermatology, Mayo Hospital, Lahore
  • Muhammad Khalil-ur-Rehman Punjab University College of Pharmacy, University of the Punjab, Lahore
  • Shahbaz Aman Department of Dermatology, Mayo Hospital, Lahore
  • Tahir Jamil Department of Dermatology, Mayo Hospital, Lahore

Keywords:

Intralesional, Vitamin D3, Human papillomavirus (HPV), Cutaneous warts

Abstract

Objective The objective of this study was to see the efficacy of intralesional vitamin D3 injection in treatment of warts. The efficacy was assessed in the term of ≥50% improvement in warts after treatment at 3rd month.   Methods This was a descriptive case series study and was completed in 6 months duration in dermatology department, Mayo hospital Lahore. A total of 97 cases of cutaneous warts fulfilling inclusion criteria were enrolled after getting approval from hospital ethical committee. All cases were included through OPD of Dermatology, Mayo Hospital Lahore after taking informed consent. Initially, lesions were anaesthetized with 0.1 ml of prilocaine (20 mg/ml). A 21-gauge syringe was used to inject 0.2 ml of vitamin D3 (7.5 mg/ml) slowly into the base of each wart. According to the treatment protocol, injections of vitamin D3 were given monthly with a maximum of 2 sessions. Per single session, the total amount injected into a patient was 7.5 mg. The whole procedure was done by consultant dermatologist having more than 5 years of experience. The treatment response ≥ 50% was recorded as per operational definition at 3rd month. All data was recorded by researchers themselves on the prescribed proforma.   Results The mean age of all cases was 40.94±11.53 with minimum and maximum age as 18 and 60 years. There were 56 (57.7%) male and 41 (42.3%) female cases. A total of 79 (81.4%) cases achieved efficacy of treatment while in 18 (18.6%) cases efficacy was not seen. Efficacy was seen in 77.5% cases who had duration of disease < 6 months and 92.3% of cases who had duration of disease since ≥ 6 months. The frequency of efficacy was statistically same in both genders and both duration of disease groups. These results showed that intralesional vitamin D3 was effective in the treatment of different types of cutaneous warts with high significance level.   Conclusion It was concluded that intralesional vitamin D3 injection was highly effective in treatment of cutaneous warts. Hence, intralesional vitamin D3 being an effective, inexpensive and safe treatment must be opted for this common problem in our society.  

References

Aldahan AS, Mlacker S, Shah VV, Kamath P, et al. Efficacy of intralesional immunotherapy for the treatment of warts: A review of the literature. Dermatol Ther.2016;29(3):197-207.

Kumar N, Warren CB. Photodynamic therapy for dermatologicconditions in the pediatric population: a literature review. PhotodermatolPhotoimmunol Photomed. 2017;33(3):125-34.

Khozeimeh F, Azad FJ, Oskouei YM, Jafari M,et al. Intralesional immunotherapy comparedto cryotherapy in the treatment of warts. Int J Dermatol. 2017;56(4):474-8.

López GS, Domínguez LM, Leyva JR, et al. General aspects of structure, classification and replication ofhuman papillomavirus. Rev Médica Inst Mex Seguro Soc. 2015;53:166-171.

Yousefi Z, Aria H, GhaedrahmatiF,et al.An update on human papilloma virus vaccines: history, types, protection, and efficacy. Front. Immunol.2022;12:1-11

Handler NS, Handler MZ, Majewski S, Schwartz RA. Humanpapillomavirus vaccine trialsand tribulations: vaccine efficacy. J Am AcadDermatol. 2015;73(5):759-67.

Singh S, Chouhan K, Gupta S. Intralesional immunotherapy withkilled Mycobacterium indicus pranii vaccine for the treatment of extensivecutaneous warts. Indian J DermatolVenereol Leprol.2014;80(6):509-14.

Ghadgepatil SS, Gupta S, Sharma YK.Clinioepidemiological study of different types of warts.Dermatol Res Pract.2016:1-4

WitcheyDJ, Witchey NB, Roth-Kauffman MM, Kauffman MK. Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management.Osteopath Med.2018;118(2): 92-105.

Hussain F, Ormerod A. Nongenital warts: clinical features andrecommended treatment. Prescriber. 2009;20(22):20-6.

Nofal A, Nofal E, Yosef A, Nofal H. Treatment of recalcitrant wartswith intralesional measles, mumps, and rubella vaccine: a promisingapproach. Int J Dermatol. 2015;54(6):667-71.

Nofal A, Yosef A, Salah E. Treatment of recalcitrant warts withBacillus Calmette-Guerin: a promising new approach. Dermatol Ther.2013;26(6):481-5.

Aktas H, Ergin C, Demir B, Ekiz O. Intralesional Vitamin D InjectionMay Be an Effective Treatment Option for Warts. J Cutan Med Surg.2016;20(2):118-22.

Raghukumar S, Ravikumar BC, Vinay KN, Suresh MR, Aggarwal A,et al. Intralesional Vitamin D3 Injection in the Treatment of recalcitrant Warts: A Novel Proposition. J Cutan Med Surg. 2017;21(4):320-4.

Rivera A, Tyring SK. Therapy of cutaneous human papillomavirusinfections. Dermatol Ther. 2004;17(6):441-8.

Bacelieri R, Johnson SM. Cutaneous warts: an evidence-basedapproach to therapy. Am Fam Physician. 2005;72(4):647-52.

Nofal A, Salah E, Nofal E, Yosef A. Intralesional antigenimmunotherapy for the treatment of warts: current concepts and futureprospects. Am J Clin Dermatol. 2013;14(4):253-60.

Kavya M, Shashikumar BM, Harish MR, Shweta BP. Safety and efficacy of intralesional vitamin D3 in cutaneous warts: An open uncontrolled trial. J Cutan Aesthet Surg. 2017;10(2):90-4.

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Published

2023-10-12

How to Cite

1.
Masood A, Ilyas N, Riaz S, Raza N, Ashraf B, Mubeen S, Khalil-ur-Rehman M, Aman S, Jamil T. The outcome of intralesional vitamin D3 (alphacalcidol) injection in treatment of cutaneous warts. J Pak Assoc Dermatol [Internet]. 2023Oct.12 [cited 2024Oct.10];33(4):1280-4. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/2344

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