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Intralesional immunotherapy compared to cryotherapy in the treatment of warts

Khozeimeh, F ; Sharif University of Technology | 2017

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  1. Type of Document: Article
  2. DOI: 10.1111/ijd.13535
  3. Publisher: Blackwell Publishing Ltd , 2017
  4. Abstract:
  5. Background: Warts are the most common clinical manifestation of the human papilloma-virus infection in the skin and mucous membranes. In spite of the various therapeutic modalities for nongenital skin warts, there is still no single method to be used as an approved treatment. In this study, we compared the efficacy of immunotherapy and cryotherapy on wart lesions. Methods: Sixty patients with verruca vulgaris and plantar warts were randomly divided into two groups. One group received intralesional injection of candida antigen repeated every 3 weeks until complete improvement of all warts or for a maximum of three sessions. The second group was treated by cryotherapy with liquid nitrogen for a maximum of ten sessions or until clearance of all lesions. T-test and chi-square test were used for statistical analysis, and P < 0.05 was considered statistically significant. Results: The patients showed a significant therapeutic response to immunotherapy compared to cryotherapy (P = 0.023). Moreover, a significant difference was observed between the time-elapsed before treatment and the therapeutic response between both groups (P = 0.041). 76.7% of patients were completely cured with immunotherapy, while only 56.7% responded to cryotherapy. Complete remission was observed with fewer sessions (20.17 ± 0.65) in immunotherapy compared to cryotherapy (3.82 ± 2.481), but no statistically significant difference was shown between groups. Immunotherapy was well-tolerated except for the pain during injection that was the most common side effect. Conclusions: Intralesional immunotherapy is an effective treatment of warts. This method has a better therapeutic response, needs fewer sessions, and is capable of treating distant warts. © 2017 The International Society of Dermatology
  6. Keywords:
  7. Candida antigen ; Liquid nitrogen ; Fungus antigen ; Article ; Blister ; Comparative effectiveness ; Controlled study ; Disease duration ; Erythema ; Flu like syndrome ; Human ; Immunotherapy ; Infection ; Injection pain ; Major clinical study ; Pruritus ; Randomized controlled trial ; Remission ; Single blind procedure ; Skin induration ; Skin pruritus ; Skin test ; Time to treatment ; Treatment duration ; Treatment response ; Verruca plantaris ; Verruca vulgaris ; Adverse effects ; Comparative study ; Immunology ; Intralesional drug administration ; Time factor ; Adolescent ; Adult ; Antigens, Fungal ; Candida albicans ; Cryotherapy ; Female ; Humans ; Injections, Intralesional ; Male ; Pain ; Single-Blind method ; Time factors ; Treatment outcome ; Warts ; Young adult
  8. Source: International Journal of Dermatology ; Volume 56, Issue 4 , 2017 , Pages 474-478 ; 00119059 (ISSN)
  9. URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.13535