Relative efficacy and safety of intralesional measles mumps rubella vaccine (MMR) and intralesional vitamin D in multiple and recalcitrant verrucae vulgaris

Abstract

Verrucae or Warts are the viral infection of skin and mucosae caused by Human Papilloma Virus (HPV). Destructive modalities are the mainstay of treatment. They can have their own shortcomings like pain, infection, scarring and recurrence. To overcome these, immunotherapy is the emerging modality.To study the relative efficacy and safety of intralesional Measles Mumps Rubella (MMR) vaccine and intralesional Vitamin D in the treatment of multiple and recalcitrant verruca vulgaris.50 patients with multiple (>5) and recalcitrant warts were enrolled and divided randomly into two groups (Group A and Group B): In Group A, 25 patients were injected 0.3ml MMR vaccine whereas in Group B, 25 patients were injected 0.5ml Vitamin D injection after achieving anaesthesia with 0.2ml injection Lignocaine into the largest wart at 2 weeks interval until complete clearance or for maximum of 3 injections whichever was earlier. Patients were followed up fortnightly for 12 weeks.In Group A, 19 (76%) patients showed Grade IV, 2 (8%) patients had Grade III, 3 (12%) patients had GII and only 1 (4%) patient had Grade I improvement. In Group B on the other hand, 15 (60%) patients showed Grade IV, 4 (16%) patients had GIII, 4 (16%) patients had Grade II and 2 (8%) patients had Grade I improvement. None of the patients developed new lesions in both groups.Both the immunotherapeutic treatments are safe, economic and less traumatic to the patients as compared to the destructive procedures for the treatment of warts.