Treatment Of Cutaneous Warts Research Articles

Assessment of peripheral blood toll-like receptor 2 expression and vitamin D serum level as predictors of response to intralesional vitamin D in the treatment of warts

Background Warts are common dermatological conditions caused by human papilloma virus. Most treatments for human papilloma virus rely on the destruction of involved tissue. The role of vitamin D injection in treating warts is thought to be via regulating cell proliferation and differentiation through the upregulation of vitamin D receptors and the induction of antimicrobial peptides. Objective To assess the clinical efficacy and safety of intralesional vitamin D in the treatment of cutaneous warts and also the significance of peripheral blood toll-like receptors 2 (TLR2) expression and serum levels of 25-hydroxyvitamin D in predicting the therapeutic success. Patients and methods In this prospective interventional study, 50 patients of cutaneous warts were subjected to history taking, proper dermatological examination, and peripheral venous blood collection for detection of TLR2 mRNA expression and a serum level of 25 (OH) D. Vitamin D3 was slowly injected into the base of the largest or the oldest wart at 2-week intervals. Results A total of 34 (69.4%) patients showed response to intralesional Vitamin D [21 (42.9%) showed complete resolution of all lesions, 13 (26.5%) showed partial clearing] and 15 (30.6%) patients showed poor or no response after four sessions. Serum level of vitamin D did not show a significant relation with treatment response. TLR2 expression was higher in the group showing complete response. Conclusion Intralesional vitamin D injection offers a safe and cost-effective therapy for different types of cutaneous warts. TLR2 expression in patients’ serum can be used to predict response to treatment by intralesional vitamin D, with better response in patients with higher expression.

Efficacy and Safety of Phoenix dactylifera L. Leaf Extract (WartOver®) in the Treatment of Cutaneous Warts: A Randomized, Double-Blind, Placebo-Controlled Trial

Background. Cutaneous warts are caused by the human papillomavirus that can affect a patient’s quality of life. Current treatments have high cost, low efficacy, adverse effects, and recurrence. Therefore, novel therapeutic approaches are needed. Complementary and Alternative Medicines (CAMs) are gaining popularity as a therapeutic approach. Phoenix dactylifera L. (date palm) is used in folk medicine to treat warts. Antiviral effects of P. dactylifera L. have been demonstrated due to its polyphenolic compounds, especially gallic acid and tannins in various studies. So, this trial evaluates the efficacy and safety of P. dactylifera L. leaf extract (formulated as WartOver®) as a novel treatment for cutaneous warts. Study Design. Based on the results of our previously published pilot clinical trial and the CONSORT guideline, this randomized, double-blind, and placebo-controlled study was performed on 70 eligible patients divided into intervention and placebo groups (N = 35/per group). Every 2 weeks, patients were examined to assess the rate of complete clearance, duration of treatment, patient satisfaction (measured using a Likert scale), and occurrence of any adverse effects and recurrence in a maximum of 12 weeks of treatment and at the 6-month follow-up. Results. Based on the intention-to-treat (ITT) analysis approach, complete clearance was achieved in 24 patients in the intervention group (68.57%; confidence interval 95% = 0.51–0.81), which was significantly higher than that in the placebo group (8.57%; CI 95% = 0.02–0.23, p<0.0001). The time to complete clearance was 7.6 weeks (mean ± SD: 53.30 ± 17.17 days). The treatment was very satisfactory (Likert score of 4.24 ± 1.15 (mean ± SD)) with no recurrence or adverse effects. Conclusion. WartOver® is a novel efficacious treatment for cutaneous warts with minimal risk for adverse events or recurrence. Due to the rising popularity of CAM approaches in medicine, including herbal medicines, WartOver® can be a valuable choice for clinicians against cutaneous warts. This trial is registered with IRCT20200509047352N2.

Progress in the treatment of Cutaneous warts

Viral warts are caused by HPV infection and result in the formation of benign proliferative lesions in humans. The diagnosis of viral warts is relatively simple and can be made on the basis of lesion characteristics, physical examination, laboratory tests and histopathology. Clinically, warts can be classified as common warts, flat warts, plantar warts, condyloma acuminatum and epidermodysplasia verruciformis. As warts tend to recur during treatment, a combination of treatments is more likely to prevent recurrence. This article is a review of advances in the treatment of warts. The aim of this article is to provide guidance to more dermatology clinicians to better understand the optimal choice of clinical treatment for warts.

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

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.

Comprehensive succinylome analyses reveal that hyperthermia upregulates lysine succinylation of annexin A2 by downregulating sirtuin7 in human keratinocytes

Abstract Background and Objectives Local hyperthermia at 44°C can clear multiple human papillomavirus (HPV)-infected skin lesions (warts) by targeting a single lesion, which is considered as a success of inducing antiviral immunity in the human body. However, approximately 30% of the patients had a lower response to this intervention. To identify novel molecular targets for anti-HPV immunity induction to improve local hyperthermia efficacy, we conducted a lysine succinylome assay in HaCaT cells (subjected to 44°C and 37°C water baths for 30 min). Methods The succinylome analysis was conducted on HaCaT subjected to 44°C and 37°C water bath for 30 min using antibody affinity enrichment together with liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results were validated by western blot (WB), immunoprecipitation (IP), and co-immunoprecipitation (Co-IP). Then, bioinformatic analysis including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, motif characterization, secondary structure, and protein-protein interaction (PPI) was performed. Results A total of 119 proteins with 197 succinylated sites were upregulated in 44°C-treated HaCaT cells. GO annotation demonstrated that differential proteins were involved in the immune system process and viral transcription. Succinylation was significantly upregulated in annexin A2. We found that hyperthermia upregulated the succinylated level of global proteins in HaCaT cells by downregulating the desuccinylase sirtuin7 (SIRT7), which can interact with annexin A2. Conclusions Taken together, these data indicated that succinylation of annexin A2 may serve as a new drug target, which could be intervened in combination with local hyperthermia for better treatment of cutaneous warts.

The Role of Intralesional Vitamin D3 injection in Treatment of Cutaneous Warts

Background: Cutaneous warts are treated primarily with destructive methods such as cryotherapy or electro-cautery. These modalities of treatment are time‑consuming and may be associated with scarring in multiple warts. Immunotherapy is emerging as a new modality of treatment that acts on enhancing cell‑mediated immunity against human papillomavirus for clearance of both treated and distant warts. Aim of the study: To show the efficacy of Intralesional vitamin D3 in treating cutaneous warts. Methods: A total of 50 patients were included in the study. They were injected with vitamin D3 300000 IU (up to 0.5 ml for each wart) at two weeks intervals for maximum of 4 sessions. The clinical response was assessed by photographic measurements at baseline, before each session, and after the completion of treatment and they were followed after 6 months for discovering any recurrence. Results: in this study among 50 patients the response rate to vitamin D3 intralesionally was 94% in general, the mild response was seen in 20(40%) patients and moderate response was seen in 16 (32%) patients while the complete response was 11 (22%) patients. No serious side effects were observed except for pain at the site of injection which most of the patients had. Limitation: small sample size with lack of control group. Conclusions: Intralesional vitamin D shows a good response in the treatment of viral warts.

Intralesional Candida albicans antigen versus intralesional zinc sulfate in treatment of cutaneous warts

Immunotherapy represents a promising therapeutic option for treatment of warts. Different concentrations of Candida antigen (1/100 and 1/1000) and zinc sulfate 2% were not previously compared regarding their efficacy in treatment of cutaneous warts. The present study compared the safety and efficacy of intralesional candida antigen versus intralesional 2% zinc sulfate for treatment of cutaneous warts. This prospective controlled clinical trial included one hundred and five patients presented with common, plantar, and plane warts. Patients were divided randomly into three groups, each group included 35 patients. Group 1 were treated with intralesional candida antigen (Ag) 1/100, Group 2 were treated with intralesional candida Ag 1/1000, and Group 3 were treated with intralesional zinc sulfate 2%. This study found that target warts of group 1 displayed higher rate of complete clearance compared to group 2 and group 3 (94.3%, 77.1, 74.2%), respectively. The present study concluded that intralesional immunotherapy with Candida antigen was more effective than Intralesional 2% zinc sulfate in treatment of cutaneous warts and less painful. Clinical trial registration number is (Clinical Trials.gov Identifier: NCT03158168).

Role of intralesioal Vitamin D in treatment of cutaneous warts

The majority of treatments for skin warts include destructive techniques like electrocautery and cryotherapy. These techniques of treatment frequently result in recurrence and scarring. Examining the safety and efficiency of intralesional vitamin D3 injection in cutaneous warts is the goal of this study.Total 50 people with recalcitrant warts of different dimensions, frequencies, and longevity participated in the study. 0.2 to 0.5 ml of vitamin D3 (600,000 IU, 15 mg/ml) were injected into the bases of warts. A maximum of 5 warts were administered per session, with sessions occurring every 2 weeks till the warts vanished, or for a total of 3 sessions. Following the final injection, individuals were monitored for six months to look for any recurrence.The trial was completed by 50 patients. Out of 50 patients, 35 (or 70%) showed a complete reaction, five (10%) showed a partial response, and ten (10%) showed no response. In every case, the distant warts completely disappeared.A safe, effective, and affordable therapy option for resistant warts is intralesional vitamin D3.

Clinical guideline for the diagnosis and treatment of cutaneous warts (2022).

Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidence-based guidelines to guide clinical practice are urgently needed. We collaborated with multidisciplinary experts to formulate this guideline based on evidences of already published literature, focusing on 13 clinical questions elected by a panel of experts. We adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form classification of recommendations as well as the improved Delphi method to retain respective recommendations with a consensus degree of over 80%. Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. It is a comprehensive and systematic evidence-based guideline and we hope this guideline could systematically and effectively guide the clinical practice of cutaneous warts and improve the overall levels of medical services.

Serum Zinc Level in Patients with Severe Genital Warts: A Case-Control Study in a Dermatology Hospital.

Background Genital warts are a common sexually transmitted disease (STD), and there is no method that completely prevents its recurrence. Recently, zinc has been used in the treatment of cutaneous warts. Nondestructive action, ease of use, and promising results with low chances of relapse were reflected in the treatment. These effects may arise from the immunomodulatory activity of zinc in the event of a viral infection. Objectives This study was aimed at identifying the relationship between the serum zinc level and the clinical characteristics of patients with genital warts. Materials and Methods A case-control study was conducted. Genital warts were diagnosed by clinical examination, and disease severity was demonstrated based on the number of affected sites or the spread of lesions. The serum zinc level was measured using atomic absorption spectrophotometry. Results A total of 78 patients with genital warts and 78 healthy volunteers were enrolled in the study. The mean serum zinc level in the genital wart group was lower than that in the control group (81.83 ± 13.99 μg/dL vs. 86.66 ± 17.58 μg/dL); however, this difference was not statistically significant (P > 0.05). The mean concentrations of serum zinc in patients having more than one affected site, spread > 2 cm2, or ten or more lesions were significantly lower than those of the control group (P < 0.05). Conclusions The results suggested that severe genital warts may be associated with a low serum zinc level in patients.

Comparison of Intralesional Vitamin D3 Injection, 5% Koh Cream and Their Combination in Treatment of Cutaneous Warts

Comparison of Intralesional Vitamin D3 Injection, 5% Koh Cream and Their Combination in Treatment of Cutaneous Warts

Home treatment of single cutaneous warts combining face-to-face and teledermatology consultation: A new perspective.

During the COVID‐19 pandemic, teledermatology services were set up and enhanced to take care of those benign conditions like cutaneous warts (CWs) which, if undiagnosed or treated with delay, could have worsened, enlarged, and potentially spread to the community. The aim of this hybrid exploratory trial was to combine face‐to‐face clinical and dermoscopic evaluation with teledermatology follow‐up in the management of CWs with a cryogenic pen based on nitrous oxide for home treatment. Twelve adult patients affected by CWs were enrolled. During the first face‐to‐face visit, single CWs were selected for the study by clinical and dermoscopic evaluation. The home schedule consisted of one application to be repeated after 2 weeks, when signs of CWs were still evident. Patients were also asked to send a clinical photo of the treated lesion at weekly intervals. A final face‐to‐face evaluation was scheduled to verify the response to home treatment by clinical and dermoscopy evaluation. A total of 20 CWs located on the trunk and the extremities were treated: a complete clinical and dermoscopic resolution was observed in 16 out of 20 lesions (80%), and a partial response in two cases. The adverse events observed during treatment were comparable to those normally observed with cryotherapy of CWs. In conclusion, home treatment of CWs with the cryogenic pen, that should be always preceded by dermatologist diagnosis and prescription, is safe and effective, especially if combined with face‐to‐face and teledermatology consultations, pointing out its important role during pandemic times or in any other environmental limitations that may impair the access to medical care services. The combination of face‐to‐face consultations for initial and final visits and teledermatology during the treatment phase could represent a model for other dermatologic conditions as well (e.g., acne, rosacea, psoriasis, atopic eczema etc.).

Therapeutic outcome and safety of intralesional vitamin d3 in the treatment of cutaneous warts

Cutaneous warts are a common but vexing condition with high recurrence rate and tendency to spread inspite of various therapeutic options. Intralesional immunotherapy is an attractive modality as it has an additional role of clearing both treated and distant warts by stimulating cell-mediated immunity against human papilloma virus. To evaluate efficacy and safety profile of intralesional Vitamin D3 formulation in the treatment of cutaneous warts. Patients with multiple cutaneous warts were injected intralesionally with Vitamin D3 (0.2 ml, 15 mg/ml) at an interval of 2 weeks for maximum of 4 sessions, and patients were followed up for 6 months. : Of the 106 patients included, complete clearance was seen in 26 (76.4 %) patients of verruca vulgaris, 20 (66.6 %) of palmoplantar warts, 18 (100 %) of plane warts, 6 (50 %) of genital and filiform warts each. Moderate response was seen in 14 (13.2%) patients while mild response was seen in 6 (5.7 %) patients. No response was seen in 10 (9.4 %) patients. No serious adverse effects were reported. : Intralesional Vitamin D3 is effective, safe, cheap and long lasting modality with a short downtime for the treatment of multiple cutaneous warts.

A comparative evaluation of therapeutic efficacy and safety of Falknor’s needling versus autoimplantation in cutaneous warts

Background: Warts, the most common manifestation caused by human papillomaviruses. Treatment is needed because of risk of transmission, cosmetic point of view, multiple, painful, and disfigurement caused by warts. Aims and Objectives: In this study, two techniques of autologous therapy are compared in terms of safety and efficacy. Falknor’s needling and autoimplantation, both are minimally invasive procedures with the aim of treating one wart and inducing immunity against the viral infected cells. Materials and Methods: Forty patients of clinically diagnosed cutaneous warts were randomly divided into two groups. In Group A, Falknor’s needling was performed on a single lesion in each patient. In Group B, autoimplantation was done by harvesting a single lesion and then implanting the tissue in subcutaneous tissue of the patient at other body site. Results: Data were analyzed using SPSS software v. 23 (IBM Statistics, Chicago, USA) and Microsoft Office 2007. Both the modalities showed excellent response (P = 0.504) in the treatment of warts with Grade 4 improvement in 85% (17 patients each) in both the modalities, with 5% of the patients showing Grade 2 and Grade 3 improvement each in needling group. Conclusion: Both the modalities of autologous therapy are simple, easy to perform, safe, and cheap modalities with excellent results in the treatment of cutaneous warts.

Intralesional Acyclovir: A Potential Therapeutic Option for Cutaneous Warts

The treatment of warts is challenging and the development of an antiviral drug that can eradicate the human papilloma virus (HPV) is difficult. The viral origin of warts suggests that acyclovir, an antiviral drug with a proven efficacy in DNA viruses, may be a potential therapeutic option. To evaluate the efficacy and safety of intralesional acyclovir in the treatment of cutaneous warts. Thirty-one patients with cutaneous warts were allocated into 2 groups. Group A (19 patients) had intralesional acyclovir (70 mg/ml) injected into the warts, while group B (12 patients) received intralesional saline as control. The treatment was repeated at 2 week intervals until complete clearance or for a maximum of 5 sessions. Complete clearance of warts was observed in 52.6%, partial response in 36.8%, and no response in 10.5% of the patients in the acyclovir group. Partial response was reported in 16.7%, and no response in 83.3% of the patients in the control group. A high statistically significant difference was found between the treatment and control groups (P < .01). Adverse effects included pain during injection in 89.5%, blistering in 52.6% and erythema in5.3% of the patients. No recurrence was detected during the follow-up period. Intralesional acyclovir can be an effective and well-tolerated treatment modality for cutaneous warts.

A Randomized, Double-Blind, Placebo-Controlled, Pilot Trial of Individualized Homeopathic Medicines for Cutaneous Warts.

Though frequently used in practice, research studies have shown inconclusive benefits of homeopathy in the treatment of warts. We aimed to assess the feasibility of a future definitive trial, with preliminary assessment of differences between effects of individualized homeopathic (IH) medicines and placebos in treatment of cutaneous warts. A double-blind, randomized, placebo-controlled trial (n = 60) was conducted at the dermatology outpatient department of D.N. De Homoeopathic Medical College and Hospital, West Bengal. Patients were randomized to receive either IH (n = 30) or identical-looking placebo (n = 30). Primary outcome measures were numbers and sizes of the warts; secondary outcome was the Dermatology Life Quality Index (DLQI) questionnaire measured at baseline, and every month up to 3 months. Group differences and effect sizes were calculated on the intention-to-treat sample. Attrition rate was 11.6% (IH, 3; placebo, 4). Intra-group changes were significantly greater (all p < 0.05, Friedman tests) in IH than placebo. Inter-group differences were statistically non-significant (all p > 0.05, Mann-Whitney U tests) with small effect sizes-both in the primary outcomes (number of warts after 3 months: IH median [inter-quartile range; IQR] 1 [1, 3] vs. placebo 1 [1, 2]; p = 0.741; size of warts after 3 months: IH 5.6 mm [2.6, 40.2] vs. placebo 6.3 [0.8, 16.7]; p = 0.515) and in the secondary outcomes (DLQI total after 3 months: IH 4.5 [2, 6.2] vs. placebo 4.5 [2.5, 8]; p = 0.935). Thuja occidentalis (28.3%), Natrum muriaticum (10%) and Sulphur (8.3%) were the most frequently prescribed medicines. No harms, homeopathic aggravations, or serious adverse events were reported. As regards efficacy, the preliminary study was inconclusive, with a statistically non-significant direction of effect favoring homeopathy. The trial succeeded in showing that an adequately powered definitive trial is both feasible and warranted. CTRI/2019/10/021659; UTN: U1111-1241-7340.

Role of Intralesional Vitamin D3 in the Treatment of Cutaneous Warts.

Background:Cutaneous warts are common benign skin lesions caused by human papillomavirus. Various treatment options are available for these but immunotherapy is becoming more and more popular over the past few years. It stimulates cell-mediated immunity causing clearance of warts.Aims and Objectives:The aim is to determine the role of intralesional vitamin D3 in the treatment of warts.Materials and Methods:Consecutive patients with verruca vulgaris attending OPD were included. Around two to three warts were injected first with 0.2 mL of lignocaine (20 mg/mL). After a few minutes, the same warts were injected with 0.2 mL (4 U) of vitamin D3 (15 mg/mL). The injections were given2 weeks apart for a maximum of six sessions, and the patient was followed up 3 months after the last injection.Results:A total of 41 patients of cutaneous warts completed the study. Complete clearance was seen in 27 (65.85%) patients, partial response was seen in 11 (26.83%) patients, and three patients (7.32%) showed no response at all. The mean number of injections required for complete response was four. Recurrence was seen in two patients (4.88%) and one patient had keloid formation at the sight of injection.Limitation:This is a small sample sized study and lacks a control group.Conclusion:Intralesional vitamin D3 is an effective treatment option for common warts.

Efficacy of intralesional MMR vaccine for the management of cutaneous warts in adults

Background: No single treatment for warts has proven 100% efficacy and most therapeutic modalities remain unsatisfactory. Immunotherapy with Measles-Mumps-Rubella (MMR) vaccine remains a key treatment of interest. The study done from August 2020 to March 2021 in the department of Dermatology, KIMS hospital, Narketpally. Telangana state.Objective: To evaluate the efficacy of intralesional MMR vaccine in the treatment of cutaneous warts in adults. Patients and Methods: Fifty patients (34 men and 16 women) aged 18–61 (mean ± standard deviation = 34.58 ± 11.74) years with common warts received 0.25 ml of MMR vaccine injected intralesionally in the largest wart. The dose was repeated at 2-week interval until complete clearance or for a maximum of 5 doses. Thereafter, they were followed up once a month for 24-week study period. The response was evaluated as complete clearance (complete disappearance of the wart(s) including distant ones and appearance of normal skin), partial clearance (≤99% reduction in size and number including distant ones and few residual warts still visible), good response (some reduction in size only including that of distant ones but no decrease in number of warts), or poor response (no change in size and number). Results: 50 patients completed the study and 29 (58%) of them had complete clearance of warts, 14 (28%) showed partial clearance and 5 (10%) patients showed good response. Complete clearance of warts occurred after five doses in 19 (38%) patients and after 4 doses in 9 (18%) patients. Conclusion: MMR vaccine is a promising treatment modality for common warts, particularly the multiple and recalcitrant ones. It seems to be inexpensive, effective and safe option that has the potential advantages of widespread and sustained effects against HPV. Intralesional MMR also appears to be much less painful and safe than traditional destructive methods for wart treatment, and thus seems to be better tolerated.

A comparative study of the efficacy and safety of intralesional measles, mumps, and rubella vaccine versus intralesional vitamin D3 for the treatment of warts in children.

Intralesional vitamin D3 has recently emerged as a new treatment for cutaneous warts. The use of the measles, mumps, and rubella (MMR) vaccine for this purpose is an established modality. However, relevant data on the efficacy of either the MMR vaccine or vitamin D3 as immunotherapy for cutaneous warts in the pediatric population are limited. To compare the efficacy and safety of intralesional injections of MMR vaccine to intralesional injections of vitamin D3 in children aged 8-16years with multiple warts. A total of 74 children were randomly allocated into two groups. Group A patients received intralesional MMR vaccine into the largest wart, and group B received intralesional vitamin D3 into the largest wart. The injections were repeated every 4weeks until clearance or for a maximum of three treatments. After the last injection, children were followed up every 2weeks for 3months, and at the sixth month, a final clinical assessment was conducted. Of 74 children, 60 completed the study, with 30 children in each group. Complete clearance of the injected wart was observed in 26 (86.67%) patients in the MMR group (group A) and 23 (76.7%) patients in the vitamin D3 group (group B). Distant warts cleared in 23 (76.7%) patients in group A compared to 20 (66.6%) patients in group B. There was no significant difference between groups. No recurrence was seen in group A, whereas two (6.6%) children in group B exhibited recurrence in the ensuing 6-month follow-up. The most common adverse events were injection site pain and swelling. Both intralesional MMR and vitamin D3 are safe, generally well-tolerated, and equally effective in children for the treatment of cutaneous warts.

Effectiveness of measles, mumps and rubella vaccine as immunotherapeutic agent for cutaneous viral warts

&lt;p&gt;Immunotherapy for management of cutaneous wart with measles, mumps and rubella vaccine (MMR) is a promising new modality of management. Evaluation of the same has been done by various studies over the years reporting its effectiveness. A literature search was done using PubMed and google scholar. This short narrative review documents the response rates in various clinical studies done till 2019 which have reported the efficacy of MMR vaccine as an immunotherapeutic agent which ranged from 26-84% graded as complete response which is complete clearance of the treated warts. These studies were performed for evaluating MMR vaccine as single agent or done in comparison with other therapeutic agents. The broad range of responses points to a need of doing further clinical studies which will substantiate the effectiveness of MMR vaccine in the treatment of cutaneous warts.&lt;/p&gt;