Intralesional Measles Research Articles

The efficacy of 20% salicylic acid solution versus intralesional MMR vaccine combination with 20% salicylic acid solution in treatment of plane wart

Background and objectives: Plane wart treatment is challenging; modalities such as cauterization and cryotherapy having a great probability to recur, as well as the risk of scarring, discomfort, and expensive costs. The goal of this study is to compare the efficacy of salicylic acid 20% superficial chemical peel alone to topical salicylic acid solution 20% combined with intralesional measles mumps rubella vaccine. Methods: A therapeutic clinical trial conducted in outpatient department of “Shahid Nabaz Dermatology Teaching Center” a period from March to September of 2022.Fifty participants with plane wart were enrolled in this study, 27 female and 23 male. The participants were randomly divided into two groups, group­- A 25 patients, received topical 20% salicylic acid solution with intralesional measles-mumps- rubella vaccine. Group B, received topical 20% salicylic acid solution alone. The total number of therapeutic sessions was six, and the solution was applied every two weeks and the measles-mumps-rubella vaccine was injected every fortnightly. Every two weeks, the effectiveness of the treatment was assessed by counting the number of lesions. Result: Group A patients who were treated with intralesional measles mumps-rubella-vaccine combined with topical 20% salicylic acid solution showed complete clearance (24/25) with six sessions .group B patients treated with topical 20% salicylic acid solutions showed clearance (14/25) with six sessions. Lesions were significantly fewer in Group-A, which was statistically significant. Conclusion: The intralesional measles mumps-rubella-vaccine combination with 20% topical salicylic acid solution and the 20% salicylic acid solution alone were both effective in clearing plane warts, however, intralesional measles mumps-rubella-vaccine combination with 20% topical salicylic acid solution can achieve higher response with fewer sessions .

A Comparative Study of the Efficacy of Intralesional Measles Mumps Rubella (MMR) Vaccine and Auto Implantation for the Treatment of Periungual and Palmoplantar Warts: A Randomized Controlled Trial.

Warts are benign epidermal proliferations, caused by infection of keratinocytes with human papillomavirus (HPV). Auto implantation and intralesional mumps, measles, and rubella (MMR) vaccine are novel methods of immunotherapy for treating periungual and palmoplantar warts. They act by stimulating the patient's immune system; this clears not only the local warts but also distant warts with lesser side effects. We conducted this study to compare the efficacy and safety of both methods in treating periungual and palmoplantar warts. A total of 160 patients were randomly allocated into two groups of 80 patients. Group A was treated with 0.3 mL of intralesional MMR vaccine at an interval of 3 weeks or for a maximum of three sittings, and Group B was treated with auto implantation. At the end of therapy, the result was better in group A (MMR vaccine) as 86% of cases yielded an excellent response as compared to 71% in group B (auto implantation). The recurrence rate was 5% in group A and 4% in group B. There were no serious side effects in both groups with pain during injection (70%) in group A and swelling at the recipient site (8%) in group B being the most common side effect. Both MMR and auto implantation had significant response rates. But MMR was faster and better.

Effectiveness of Oral Zinc Therapy as an Adjunct to Intralesional Measles, Mumps, and Rubella Vaccine in Patients of Verruca Vulgaris

Abstract Background: Verruca vulgaris (VV) is caused by human papillomavirus affecting both keratinized and nonkeratinized epithelium. Different treatment modalities are available leading to scarring, pain, and ineffectiveness. Injection of measles, mumps, and rubella (MMR) not only clears treated warts but also distant warts by stimulating cell-mediated immunity. Objectives: The objective of this study was to study the efficacy of adjuvant zinc with injectable MMR vaccine in treatment with side effects of treatments, the pattern of regression, the number of injections required for clearance, and the recurrence of verruca. Materials and Methods: Fifty patients having verruca were divided into groups A and B with 25 patients each. Group A received an injection of MMR and tablet of zinc whereas group B only injection MMR. A total of five injections were given in the largest wart at intervals of 2 weeks i.e., 0, 2, 4, 6, and 8 weeks. Follow-up was done at 3rd month and 6th months following 1st dose. Improvement in warts and patient satisfaction were assessed using visual analog scale and Likert scale, respectively. Results: Mean age of patients in groups A and B was 30.36 and 32.68 with male-to-female ratio 5.28:1 (21:4) and 1.77:1 (16:9), respectively. Mean numbers and size of lesions in group A and B were 2.24 (±1.59), 1.84 (±1.40) and 5.52 mm, 5.08 mm, respectively. Eighty-four percentage of patients in both groups needed five injections for complete clearance. Pain was the most common side effect in all patients of both groups whereas gastritis, fever, and lymphadenopathy were observed only in one patient of Group A. Patients in both groups were strongly satisfied on Likert’s scale. Conclusion: Oral zinc as an adjuvant with MMR vaccine for the treatment of VV was equally safe but did not prove to be of higher efficacy in our study.

Comparative Study of Intralesional Measles–Mumps–Rubella Vaccine versus Needling-Induced Autoinoculation in the Management of Genital Warts

Abstract Background Genital warts caused by human papillomavirus (HPV) are one of the most common sexually transmitted infections, especially among women. Genital HPV infection has a relatively long incubation period up to 8 months. It is known to have a high recurrence rate, and the infection by certain high-risk HPV strains is known to be associated with malignancies of cervix, penis, vulva, vagina, and anus. Thus, factors such as long latency, lesions’ multiplicity, high recurrence rate, and the tendency to malignant transformation, are essential challenges during management of genital HPV infections. The clinical outcome of traditional treatment modalities; such as podophyllotoxin, imiquimod, cryotherapy, electrocautery, trichloroacetic acid, photodynamic therapy, and laser, is limited to individual lesions. Therefore, they are usually inconvenient for patients with multiple and/or recurrent lesions. Aim of the Work to evaluate the safety and efficacy of intralesional injection of MMR vaccine in comparison with needling-induced autoinoculation in the treatment of genital warts. Patients and Methods Our study included 50 patients with multiple and recurrent genital warts (more than 4 genital warts) divided into two equal matched groups. One group was subjected to MMR injection and the other subjected to needling-induced autoinoculation every two weeks for maximum three sessions. Follow-up was done for 8 weeks after last session. Results This study reports that both treatment options showed statistically significant value in treatment of genital warts, and here was no statistically significant difference between both study groups as regard response to treatment. Conclusion both MMR and needling are simple and effective modalities of immunotherapy for treatment of multiple genital warts with excellent safety profile. The only disadvantage is the long time taken for immune response to occur. Combination treatment plan can overcome this disadvantage. Needling-induced autoinoculation; being more safe and inexpensive, may be considered as a competing immunotherapeutic treatment modality for multiple and recurrent genital warts.

Intralesional measles, mumps, and rubella vaccine after failure of intralesional Candida antigen for the treatment of recalcitrant pediatric warts.

Numerous studies have investigated the efficacy of intralesional immunotherapy for warts, but there are a lack of studies investigating the efficacy of alternative intralesional immunotherapies following failure of initial intralesional immunotherapy. In this retrospective study, we aimed to investigate the efficacy of intralesional measles, mumps, and rubella vaccine for the treatment of pediatric warts following failure of intralesional therapy with Candida antigen. Following intralesional measles, mumps, and rubella vaccine administration, 8/51 (15.5%) patients had complete resolution of their warts, 6/51 (12%) had near complete resolution, 19/51 (37%) had partial improvement, 12/51 (23.5%) had no change, and 6/51 (12%) had worsening. Although limited by retrospective nature and low sample size, our results demonstrate that intralesional immunotherapy with measles, mumps, and rubella vaccine provides an alternative therapeutic option for the treatment of recalcitrant pediatric warts in patients who fail to respond to intralesional Candida antigen.

Intralesional Measles, Mumps and Rubella Vaccine versus Formic Acid Puncture in the Treatment of Common Warts: A Prospective Randomised Study.

Many therapeutic modalities have been reported for the treatment of warts: a common bothersome condition; however, no single treatment is completely effective. This study aimed to evaluate the efficacy and safety of intralesional injection of measles, mumps and rubella (MMR) vaccine and to compare its efficacy with 85% formic acid puncture for common warts. This was a prospective comparative study. A total of 60 patients, divided into two groups, were included in the study. Group A received an intralesional MMR vaccine of 0.3 ml per lesion, and group B received 85% formic acid puncture into each lesion with a maximum of 10 warts treated in each case. Five sessions were conducted every 2 weeks in each case with a follow-up period of 3 months to check for recurrence. The Chi-square test, Fisher's test and t-test were used for statistical analysis. A P-value <0.05 was considered statistically significant. In group A, the complete response was observed in 62.5%, partial response in 8% and no response in 4.1% of patients. In group B, the complete response was observed in 31.8%, partial response in 63.6% and no response in 4.5% of patients. The difference in cure rates was found to be statistically significant with a P value of 0.031. No recurrence was observed in both groups in the follow-up period. Immunotherapy by intralesional MMR vaccine is a simple, well-tolerated, effective and cost-benefit modality for the treatment of warts and showed a statistically significant cure rate than formic acid therapy.

Comparison of the Efficacy of Intralesional Measles, Mumps, and Rubella Vaccine with Intralesional Vitamin D3 for the Treatment of Extragenital Warts in Pediatric Age Group (5–18 Years)

Introduction: Warts are benign skin growths caused by human papillomavirus. Traditional methods of treatment usually include destructive modalities which are painful and scar-forming. Such modalities have disadvantage of recurrence. Consequently, immunotherapy is introduced to overcome these problems. Aims and Objectives: To study the comparative efficacy of intralesional measles, mumps, and rubella (MMR) vaccine with intralesional Vitamin D3 for the treatment of extragenital warts in the pediatric age group (5–18 years). Materials and Methods: Seventy-two immunocompetent patients aged between 5 and 18 years with multiple extragenital warts (2 or more) were enrolled and divided randomly into two groups (Group A and Group B). Group A and Group B received intralesional MMR vaccine and Vitamin D3, respectively, in the largest wart present. The injections were repeated every 2 weeks for a maximum of four injections. Results: Complete response (CR) in injected warts in Group A is seen in 25 (83.3%) patients, partial response (PR) in 3 (10%), and no or inadequate response (NR) in 2 (6.67%) patients. CR is seen in 23 (76.66%) patients of Group B, PR in 4 (13.33%) and no or NR in 3 (10%) patients. CR in distant warts in 22 (73.33%) patients in Group A and 20 (66.66) patients in Group B. Conclusion: Both MMR vaccine and Vitamin D3 are safe, efficacious, and less traumatic to the patients for multiple warts in comparison with destructive modalities.

Efficacy of Intralesional Measles Mumps Rubella Vaccine in the Treatment of Verruca Vulgaris: An Interventional Study.

Background A wart is a mucocutaneous illness caused by the growth of HPV-infected skin or mucosal cells. Intralesional immunotherapy makes use of the immune system's ability to identify injected antigens, which might cause a delayed-type hypersensitivity reaction not just to the antigen but also to the wart virus. This, in turn, improves the immune system's ability to identify and eliminate HPV not just at the treated wart but also at distant places, as well as prevent recurrences. Aims and objectives To study the efficacy of the intralesional measles, mumps, and rubella (MMR) vaccine in verruca vulgaris and its side effects. Materials and methods Interventional research with a 94-case sample size was conducted over a period of seven months. A volume of 0.3 ml of the MMRvaccination was reconstituted with sterile water and injected into the largest wart at three-week intervals until complete clearance or for a maximum of three treatments.Following a six-month observation period, patients were evaluated to look for recurrence, and the degree of response was categorized as total, partial, or none at all. Results The youngest case included in the study was of age 10 years and the eldest case was of 45 years. The mean age was 28.22± 10.98. Of 94 patients, 83 (88.3%) were men and 11 (11.7%) were women. Complete remission was reported in 38 (40.42%) cases, a partial response in 46 (48.94%) cases, and no response in 10 (10.63%) cases. All 38 patients who showed complete clearance had a duration of warts in six months or less. The pain was a universal complaint (100%) after each visit followed by bleeding at 25.53%. Flu-like symptoms were noted in three cases after the first dose and two cases after the second dose, while urticaria was seen in one case during all visits. Cervical lymphadenopathy was observed in two cases after the first dose. Erythema multiforme minor was seen only in one patient after the first dose. Conclusion Intra-lesional MMR vaccine therapy proved to be a simple and safe treatment option in cases having multiple warts. The response rate may increase if a higher concentration of vaccine (0.5ml) and additional doses (maximum of five doses) are given.

Comparative study on the effectiveness of intralesional Measles, Mumps, and Rubella vaccine and intralesional vitamin D3 injection in the treatment of verruca

Background: Human papillomavirus (HPV) is the causative agent of verruca and is contagious, recurrent, and recalcitrant due to defects in cell-mediated immunity. No single mode of treatment is completely effective. The most commonly used treatment options are destructive and lead to scarring. The emerging new modality of treatment is immunotherapy, which acts by enhancing cell-mediated immunity (CMI) against HPV to clear treated as well as remote warts. Objectives: The objective was to compare the efficacy of intralesional Measles, Mumps, and Rubella (MMR) vaccine and intralesional vitamin D3 in cutaneous warts. Materials and Methods: A randomized, hospital-based, single-blind study on forty patients divided into two groups (groups A and B), comprising twenty patients each, was conducted. In group A, intralesional MMR vaccine 0.5 mL was injected into the base of warts. In group B, intralesional vitamin D3 0.5 mL was injected into the base of warts after achieving local anesthesia. Sessions were performed in two-week intervals for a maximum number of five sessions. The patients were followed for sixteen weeks. Results: In group A (MMR vaccine), a complete response was seen in 75% (15/20) of the patients, a moderate response in 15% (3/20), a partial response in 5% (1/20), and no response in 5% (1/20). In group B (vitamin D3), a complete response was seen in 65% (13/20) of the patients, a moderate response in 15% (3/20), a partial response in 10% (2/20), and no response in 10% (2/20). No recurrence was noticed after follow-up in either of the two groups. Conclusion: Immunotherapy is an option that is easy, safe, cost-effective, and well-tolerated with minimal side effects. Key words: Verruca; Intralesional MMR; Intralesional vitamin D3; Immunotherapy

Evaluation of efficacy and safety of intralesional vitamin D3 in comparison with intralesional measles, mumps and rubella (MMR) vaccine in the treatment of multiple cutaneous warts

Evaluation of efficacy and safety of intralesional vitamin D3 in comparison with intralesional measles, mumps and rubella (MMR) vaccine in the treatment of multiple cutaneous warts

Efficacy of intralesional measles, mumps and rubella vaccine immunotherapy in Molluscum contagiosum: a prospective study

Efficacy of intralesional measles, mumps and rubella vaccine immunotherapy in Molluscum contagiosum: a prospective study

Role of intralesional measles, mumps and rubella vaccine in treatment of warts

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Objective of the research was to study the efficacy and safety of measles, mumps and rubella (MMR) vaccine in the treatment of warts.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 53 patients with single or multiple warts in all age groups were included in the study. The patients received intralesional MMR vaccine 0.5ml into a single wart or the largest wart in case of multiple lesions at interval of 3 weeks for 3 treatments. All patients were followed up every 2 months up to 6 months regarding relapses. side effects and therapeutic outcomes were evaluated.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 53 patients, 50 completed the study. Complete response was seen in 36 (72%), partial response in 09 (18%) and no response in 05 (10%) patients. 3 out of 36 patients with complete response were having recurrence of warts. Pain at the site of injection and flu like symptoms were the main side effects observed.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Intralesional immunotherapy with MMR vaccine was found to be a simple, effective, and safe treatment for warts. This study proved to be cost effective as patients can be treated with just 03 doses of MMR vaccine given at the interval of three weeks.&lt;/p&gt;

Intralesional Injection of Measles, Mumps, and Rubella Vaccine in Molluscum Contagiosum Treatment: An Experimental Study

Molluscum contagiosum (MC) is a common viral infection that affects the skin and the mucous membranes. Several studies have shown that intralesional Measles, Mumps, and Rubella (MMR) immunotherapy is beneficial for treating warts. There is very little information about the effectiveness of this treatment method in patients with MC. The study's objective was to assess whether patients with MC benefit from intralesional MMR vaccination. This experimental study was carried out on 20 patients of MC (11 men and 9 women) who visited Sulaimani Dermatology Teaching Center, who received a maximum of six doses of intralesional MMR vaccine with an interval of two weeks between sessions. Three kinds of therapy responses were identified; complete, partial, and no response. A number of side effects were recorded. The mean ± SD of the age, duration of the disease, and the number of skin lesions were 17.9 ±17.1 years, 5.1 ±2.2 months, and 10.4 ±7.9 lesions, respectively. Sixty-five percent of patients had complete clearance, 25% with partial clearance and 10% experienced no clearance. According to the examined variables, no significant difference was present in the frequency of the various treatment responses (p&gt;0.05). The noticed side effects were temporary mild redness, edema, and pain at the site of injection. Recurrence was not seen in any of the patients who responded completely to the treatment. Although it seems that intralesional MMR immunotherapy was effective and safe in the treatment of the skin lesions due to MC. To further support the results of the current study, larger prospective studies that are placebo-controlled and have longer follow-ups are required.

Intralesional Measles, Mumps, Rubella Vaccine versus Tuberculin Purified Protein Derivative Injections in the Treatment of Palmoplantar and Periungual Warts: A Double-Blind Randomized Controlled Trial

Background: Palmoplantar and periungual warts tend to be recalcitrant. Intralesional immunotherapy can provide high efficacy with additional benefit to distant warts. However, evidence on comparative effects between intralesional immunotherapy with measles, mumps, rubella vaccine (MMR) and tuberculin purified protein derivative (PPD) and roles of dermoscopy in predicting treatment outcomes in palmoplantar/periungual warts is limited. Objectives: The study aimed to compare efficacy and safety of intralesional MMR and PPD injections in treatment of palmoplantar/periungual warts and explore associations between dermoscopic findings and treatment outcomes. Methods: We conducted a double-blind randomized controlled trial involving 40 patients with palmoplantar/periungual warts who were equally assigned to receive MMR or PPD. Intralesional injection was done every 2 weeks until clearance or maximum of 5 treatments. Results: Complete resolution was higher in MMR than PPD group (90.0% vs. 80.0% in index lesion and 81.3% vs. 54.6% in distant lesions, respectively), although the differences were statistically nonsignificant. Dermoscopic findings were not significantly associated with complete resolution. Local swelling, i.e., the most common adverse event, occurred more frequently in PPD (40.0%) than MMR group (10.0%). Conclusion: This study suggests that intralesional immunotherapy with either MMR or PPD is efficacious in palmoplantar/periungual warts, with MMR showing a trend toward higher clearance and lower adverse events.

Buschke-Lowenstein tumor treated with intralesional measles, mumps, and rubella vaccine.

Buschke-Lowenstein tumor treated with intralesional measles, mumps, and rubella vaccine.

Intralesional Measles Mumps Rubella vaccine versus BCG in the treatment of multiple cutaneous warts: a comparative study

Background: Verrucae or warts are benign epithelial proliferations that occur due to accumulation of keratinocytes induced by HPV. Immunotherapy is a new promising modality which uses the principle of activation of one’s own immunity against the disease. Materials and methods: The study included 40 patients with multiple cutaneous warts in two groups of 20 each. Assigned treatment was injected into the single largest wart at an interval of 3 weeks until complete clearance or for a maximum of 3 times. Results: A statistically significant difference (p=0.018) was seen in the therapeutic response when compared to that of the BCG. All 20(100%) patients in the MMR group showed &gt;50% clearance while in the BCG group 14(70%) patients showed &gt;50% clearance according to Physician’s Global Assessment scores. Conclusions: Intralesional immunotherapy with MMR and BCG vaccines are both safe and promising whereas the therapy with MMR stands out with statistically significant results.

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

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 (&amp;#62;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.

Intralesional measles, mumps, and rubella vaccine for the treatment of recalcitrant warts: A case series and review of literature

Objectives:To document the response of recalcitrant warts to intralesional measles, mumps, and rubella (MMR) vaccine.Materials and Methods:This case series reports the treatment response to intralesional MMR vaccine observed in 11 patients who attended the dermatology outpatient department with recalcitrant warts of more than 1 year duration. Only the largest wart was treated in each case. The intralesional treatment was repeated at an interval of 2 weeks.Results:Nine patients (81.9%) showed complete response to treatment. One patient did not return for treatment after two sessions (9.1%). One showed incomplete treatment response (9.1%). The adverse reactions noted among the 11 patients were pain (3/11, 27.3%) and secondary bacterial infection (1/11, 9.1%).Limitations:Results are based on a case series of 11 patients.Conclusion:Intralesional MMR vaccine was found effective and safe in the management of recalcitrant warts.

Intralesional Measles, Mumps, and Rubella Vaccine Versus Intralesional Candida Antigen in the Treatment of Common and Plantar Warts.

Intralesional immunotherapy has been effectively used in the treatment of warts; however, comparative studies between different antigens are limited. To evaluate the efficacy and safety of intralesional measles, mumps, and rubella (MMR) vaccine compared with intralesional Candida antigen for the treatment of multiple common and plantar warts. Sixty-eight adult patients with multiple common and plantar warts were randomly assigned into two groups, each containing 34 patients. The first group received intralesional MMR vaccine, while the second group received intralesional Candida antigen. Each treatment was injected into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions. The overall therapeutic response was higher in the Candida antigen group (73.5%) compared with the MMR group (67.7%); however, the difference was not statistically significant. Complete clearance of common warts was higher in the Candida antigen group, while that of plantar warts was higher in the MMR group. Adverse effects were transient and well tolerated in both groups. No recurrence was detected during the 6-month follow-up period. Intralesional MMR and intralesional Candida antigen showed comparable efficacy and safety in the treatment of common and plantar warts.

A comparative study of therapeutic efficacy of intralesional measles, mumps, and rubella vaccine and intralesional Vitamin D3 in the treatment of recurrent warts

Background: Recurrent or resistant warts may be due to defective cell-mediated immune response. Immunotherapy is directed at manipulating the immune system to achieve an anti-human papillomavirus immune reaction. Purpose: Our study compared the safety and efficacy of intralesional measles/mumps/rubella (MMR) vaccine to intralesional Vitamin D3 injection in recurrent warts. Methods: Sixty-six patients were divided into two groups of 33 each. In Group A and B, patients were injected with 0.5 ml of Vitamin D3 and 0.5 ml of MMR vaccine, respectively, intralesionally into the base of the largest wart every 2 weeks until complete clearance or for a maximum of 4 doses. The patients were evaluated for clinical improvement and any adverse effects. Results: Complete clearance of warts was noted in 52% (17) in Group A and in 70% (23) in Group B. Excellent to complete response was noted in 82% (27) in Group A and in 91% (30) in Group B. The clinical improvement noted with intralesional MMR vaccine was not statistically different than with intralesional Vitamin D3 (P > 0.05). Conclusion: Intralesional MMR and Vitamin D3 are promising options for recurrent warts.