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ROLE OF INTRALESIONAL VITAMIN D3 IN THE TREATMENT OF CUTANEOUS WARTS

Authors: Shrini Parikh;

ROLE OF INTRALESIONAL VITAMIN D3 IN THE TREATMENT OF CUTANEOUS WARTS

Abstract

{"references": ["1.\tPlasencia JM. Cutaneous warts: diagnosis and treatment. Prim Care. 2000;27:423-34. 2.\tNaresh M. A Study of Effectiveness of Intralesional Vitamin D3 in Treatment of Multiple Cutaneous Warts. IOSR. 2019; 18(3):84-7. 3.\tKavya M, Shashikumar BM, Harish MR, Shweta BP. Safety and Efficacy of Intralesional Vitamin D3 in Cutaneous Warts: An Open Uncontrolled. Trial. J Cutan Aesthet Surg. 2017;10(2):90\u20134. 4.\tSavant SS, Gore D. Electrosurgery. Textbook and Atlas of Dermatosurgery and Cosmetology. Mumbai: ASCAD. 2005:305-14. 5.\tChauhan PS, Mahajan VK, Mehta KS, Rawat R, Sharma V. The efficacy and safety of intralesional immunotherapy with measles, mumps, rubella virus vaccine for the treatment of common warts in adults. Indian Dematol Online J. 2019;10(1):19-26. 6.\tSinha S, Relhan V, Garg VK. Immunomodulators in warts: Unexplored or ineffective?. Indian J Dermatol 2015;60(2):118-29. 7.\tWord AP, Nezafati KA, Cruz PD Jr. Treatment of warts with contact allergens. Dermatitis. 2015;26(1):32\u20137. 8.\tChandrashekhar L. Intralesional immunotherapy for the management of warts. Indian J Dermatol Venereol Leprol. 2011;77(3):261-3. 9.\tNofal A, Salah E, Nofal E. Intralesional antigen immunotherapy for the treatment of warts: current concepts and future prospects. Am J Clin Dermatol. 2013;14(4):253-260. 10.\t Aldahan AS et al. Efficacy of intralesional immunotherapy for the treatment of warts: a review of the literature. Dermatol Ther. 2016;29(3):197-207. 11.\tGon\u00e7alves MA, Donadi EA. Immune cellular response to HPV: Current concepts. Braz J Infect Dis. 2004;8(1):1-9. 12.\tMoscarelli L, Annuziata F, Mjeshtri A, Paudice N, Tsalouchos A, Zanazzi M, et al. Successful treatment of refractory wart with a topical activated vitamin D in a renal transplant recipient. Case Rep Transplant. 2011;2011:368623. 13.\tMaronn M, Salm C, Lyon V, Galbraith S. One-year experience with candida antigen immunotherapy for warts and molluscum. Pediatr Dermatol. 2008;25(2):189\u201392. 14.\tJaisinghani AK, Dey VK, Suresh MS, Saxena A. Bacillus Calmette Guerin Immunotherapy for Recurrent Multiple Warts: An OpenLabel Uncontrolled Study. Indian J Dermatol. 2019; 64(2): 164. 15.\tLabandeira J, V\u00e1zquez-Blanco M, Paredes C, Su\u00e1rez-Penaranda JM, Toribio J. Efficacy of topical calcipotriol in the treatment of a giant viral wart. Pediatr Dermatol. 2005;22(4):375-6. 16.\tRaghukumar S, Ravikumar BC, Vinay KN, Suresh MR, Aggarwal A, Yashovardhana DP. Intralesional Vitamin D3 Injection in the Treatment of Recalcitrant Warts: A Novel Proposition. J Cutan Med Surg. 2017;21(4):320-4. 17.\tAkta\u015f H, Ergin C, Demir B, Ekiz \u00d6. Intralesional Vitamin D Injection May Be an Effective Treatment Option for Warts. J Cutan Med Surg. 2016;20(2):118-22. 18.\tAkula ML, Shetty M, Shetty V, Patel P, Basil A. Comparative study of therapeutic efficacy of intralesional vitamin D3 versus intralesional purified protein derivative in the treatment of warts. Ind J Clin Exp Dermatol. 2018;4(3):226-31. 19.\tSingh SK, Mohan A, Gupta AK, Pandey AK. A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts. Int J Res Dermatol. 2018;4(2):197-201. 20.\tBhanot S. Evaluation of therapeutic effectiveness of vitamin D3 injections in common warts in a tertiary care centre. Int J Res Dermatol. 2019;5(3):462-5."]}

Warts are the benign cutaneous manifestations caused by human papillomavirus (HPV). All currently available treatment modalities are associated with significant side effects and frequent recurrences. As intralesional vitamin D3 is a new immunotherapeutic agent in practice, we conducted this study to determine its safety and efficacy as an immunotherapeutic agent in the treatment of cutaneous warts. We conducted this study on 60 patients. The selected warts were slowly injected with 0.1-0.5 ml of Vitamin D3 (15 mg/ml) into the base of each wart with a 26-gauge insulin syringe. A maximum of 5 warts were injected per session. The injections were performed at 2 weekly intervals until complete resolution or for a total of 4 sessions. It resulted in complete clearance in 38 out of 60 patients, while moderate response was seen in 4 patients and mild response was observed in 3 patients in terms of number of warts. Fifteen patients did not demonstrate any decrease in number of warts even after 4 sittings of intralesional Vitamin D3. In terms of size of warts, moderate response was seen in 8 patients and mild response was observed in 5 patients. Nine patients did not demonstrate any reduction in size of warts even after 4 sittings of intralesional Vitamin D3. Immunotherapy with vitamin D3 seems to be a promising, effective, simple, inexpensive and safe treatment modality for the treatment of cutaneous warts. Due to low recurrence rates, it can be considered to have potential advantages of widespread and sustained effects against HPV.

Keywords

intralesional immunotherapy, vitamin D3, warts

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