Comparative Efficacy of Liquid Nitrogen versus Vitamin D3 in the Treatment of Cutaneous Warts

Abstract

Background: Cutaneous warts, caused by the human papillomavirus (HPV), pose both cosmetic and psychological burdens on affected individuals. Traditional treatment options like cryotherapy have been effective but can be invasive and painful. Vitamin D3 emerges as a potential non-invasive alternative, with its immunomodulatory properties suggesting efficacy in wart treatment. Objective: To compare the efficacy and side effects of liquid nitrogen cryotherapy versus intralesional vitamin D3 in the treatment of cutaneous warts on the hands and feet. Methods: This randomized controlled trial was conducted at the Department of Dermatology, CMH Abbottabad, from May to November 2022, with ethical approval obtained from the Ethical Committee (Ref: CMHAtd-ETH-18-DERM-22). Sixty patients diagnosed with cutaneous warts were randomly assigned to either cryotherapy with liquid nitrogen (Group A) or intralesional vitamin D3 (Group B). The primary outcome measured was the percentage reduction in wart size, with treatment efficacy defined as a reduction of 50% or more. Side effects were also recorded. Statistical analysis was performed using SPSS version 23.0, employing chi-square tests for categorical variables, with a p-value of less than 0.05 considered significant. Results: The mean age was 36.17±11.844 years in Group A and 41.10±12.383 years in Group B. Efficacy rates showed that 90% of patients in Group A and 76.7% in Group B achieved the defined treatment success. Side effects were minimal and similar across both groups, with 13.3% in Group A and 16.7% in Group B experiencing blisters or pain. The difference in treatment efficacy was not statistically significant (p=0.166). Conclusion: Both liquid nitrogen cryotherapy and intralesional vitamin D3 are effective treatments for cutaneous warts, with minimal side effects. While cryotherapy showed a slightly higher efficacy rate, the substantial success of vitamin D3 makes it a promising alternative for patients. This study contributes to the diversification of treatment modalities available for cutaneous warts, potentially enhancing patient outcomes and satisfaction.