25729 Efficacy of human papillomavirus vaccination as treatment for verruca vulgaris: A retrospective, single-institutional study

Abstract

Verruca vulgaris is a common, benign neoplasm of the skin caused by human papillomavirus (HPV) infection. Although many therapeutic options exist and spontaneous resolution is not uncommon, there is no definitive cure for warts. Furthermore, recalcitrant cases can cause considerable morbidity. Recently, reports of complete resolution of common warts following HPV vaccination have been documented. However, no large-scale retrospective comparison cohort studies have investigated this therapeutic effect. To evaluate the efficacy of HPV vaccination as treatment for common warts, we conducted the first retrospective cohort study on 2154 patients with a diagnosis of verruca vulgaris from a large, urban academic hospital system. Patients were stratified by HPV vaccination status (unvaccinated, vaccinated prior to wart diagnosis, or vaccinated during wart follow-up), and therapeutic response in each group was assessed. Additional variables analyzed included age, sex, number and location of warts, and alternate treatment modalities used. In contrast to previous reports, our study’s stratified and combined analyses did not detect a significant difference in wart resolution among vaccinated and unvaccinated patients, regardless of the timing of vaccination in relation to wart diagnosis. Our work shows that the effect of HPV vaccination on wart resolution requires further investigation, ideally in a controlled prospective study in which investigators determine vaccination dates. However, it may be reasonable to begin vaccination in unvaccinated patients who require treatment for warts considering the known benefit of HPV vaccination in preventing malignancies and low rates of adverse effects.