Combined oral isotretinoin and Candida antigen versus either agent alone in the treatment of plane warts

Abstract

Background Oral isotretinoin and intralesional immunotherapy by Candida antigen have shown promising efficacy and safety for the treatment of plane warts in a few studies. Objective To evaluate the efficacy and safety of a combination of oral isotretinoin and Candida antigen versus either agent alone in the treatment of multiple plane warts. Methods The study included 108 patients who were randomly assigned to three groups, 36 in each. Group 1 received oral isotretinoin alone at a dose of 0.3 mg/kg/day. Group 2 received intralesional injection of Candida antigen alone at a dose of 0.1 ml of 1/1000 solution into the largest wart. Group 3 received a combination of Candida antigen and oral isotretinoin by the same method and dose mentioned above. Results Complete clearance of warts was observed in 44.4% of the oral isotretinoin alone group, in 55.6% of the Candida antigen alone group, and in 38.8% of the combination therapy group. A statistically significant difference in favor of the Candida antigen alone group was demonstrated. Conclusions Candida antigen, oral isotretinoin and a combination of both represent potential effective and safe modalities for the treatment of plane warts, with the Candida antigen alone as the most effective.