Intralesional Immunotherapy Shows Promising Results for Warts

Warts, caused by the human papillomavirus (HPV), are common skin and mucosal growths. While various treatments exist, no single approach has been consistently effective, leading researchers to explore immunotherapy as a potential solution for refractory cases.

In a two-year study conducted at a tertiary care center in South Korea published in Indian Dermatology Online Journal, researchers team led by Chaudhary Malay investigated four intralesional immunogens for treating warts: measles mumps and rubella (MMR) vaccine, purified protein derivative (PPD), Candida extract, and vitamin D3. This open-label,

randomized, prospective study involved 100 patients with multiple cutaneous warts, and each group received one of the four immunotherapeutic agents.

● The results revealed that intralesional vitamin D3 had the highest efficacy, with 100% clearance at the local wart site.

● Intralesional Candida antigen showed the most significant efficacy at both local and distant wart sites (80% clearance).

● Intralesional MMR vaccine demonstrated a 68% clearance at the local site and 60% at distant sites, while PPD had an 84% clearance at the local site and 72% at distant sites.

The study highlighted that immunotherapies were well-tolerated, with minimal side effects. However, it is essential to note that individual responses to different immunotherapeutic agents can vary due to differences in immunity, HPV serotype, and infection severity.

Warts can cause physical discomfort and psychological distress, making effective treatment crucial. Traditional destructive treatments can leave scars and may not stimulate host immunity adequately, leading to recurrences. Intralesional immunotherapies aim to induce cell-mediated immunity and affect both local and distant warts, making them an attractive option for large and multiple wart cases.

Further research is needed to identify type-specific differences in therapy and expand treatment options for warts. Overall, the study's findings suggest that immunotherapy holds promise in providing a safe and effective treatment for refractory warts.

Reference:

Jagati, A., Chaudhary, M., Brar, A., Agarwal, P., Chavda, V., & Rathod, S. (2023). A study of comparison and evaluation of various intralesional therapies in cutaneous warts. Indian Dermatology Online Journal, 14(4), 487. https://doi.org/10.4103/idoj.idoj_492_22