Vitamin D3 Versus Methotrexate Versus Saline Injections for Plantar Warts

November 8, 2026 updated by: Noura Abdelmoneim Mohammed Elseessy, Kafrelsheikh University

Clinical and Dermoscopic Evaluation of Efficacy and Safety of Intralesional Injection of Vitamin D3 Versus Intralesional Injection of Methotrexate in Plantar Warts

This clinical trial will compare vitamin D3 injections, methotrexate injections, and saline injections for plantar warts. Plantar warts are warts on the soles of the feet. The study will include 60 adults aged 18 to 50 years at Kafrelsheikh University Hospital, Egypt.

The main questions are:

  • How well does each treatment clear plantar warts?
  • What side effects occur with each treatment?
  • Do the warts return after treatment?

Participants will be assigned by chance to one of three groups, with 20 participants in each group:

  • Vitamin D3 injections into the warts.
  • Methotrexate injections into the warts.
  • Saline injections into the warts. Saline is a saltwater solution used as a placebo comparison.

Participants will receive injections once a week until their

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This randomized, controlled, three-arm, parallel-group clinical trial will evaluate the efficacy and safety of intralesional vitamin D3 and intralesional methotrexate compared with intralesional saline placebo for plantar warts. The protocol describes the study as double-blind.

Participants will be recruited from the outpatient clinics of the Department of Dermatology and Venereology, Kafrelsheikh University Hospital, Egypt. Plantar warts will be diagnosed clinically, with dermoscopic examination used when the diagnosis is uncertain. Sixty eligible participants will be randomly assigned to three groups of 20 participants each.

Baseline evaluation will include medical history, wart duration, previous treatments, recurrence history, general examination, and assessment of wart size and number. Laboratory investigations will include a complete blood count, liver and kidney function tests, and serum calcium measurement before treatment and one week after the final treatment session.

Treatment sessions will take place weekly until complete clearance or a maximum of six sessions. Before injection, a topical lidocaine/prilocaine anesthetic cream will be applied under occlusion for one hour. The treatment area will then be cleaned with 70% alcohol. Assigned treatment will be injected into the base of the wart using a 27-gauge insulin syr

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age 18 to 50 years.
  • Clinical diagnosis of plantar warts, with dermoscopic confirmation when the diagnosis is uncertain.
  • Willingness to participate and provide written informed consent.

Exclusion Criteria:

  • Pregnancy or breastfeeding.
  • Use of systemic or topical treatments for warts within the month before enrollment.
  • Immunosuppressive diseases or current use of immunosuppressive drugs.
  • Hypercalcemia.
  • Renal disease or renal impairment.
  • Known hypersensitivity to any ingredient of the investigational products.
  • History of chronic disease, including hepatic disease or bleeding diathesis.
  • Local inflammation or infection.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intralesional Vitamin D3

Twenty participants will receive intralesional cholecalciferol (vitamin D3) injections into the base of plantar warts. A volume of 0.2-0.4 mL will be injected per lesion, treating a maximum of five warts per session. Sessions will take place weekly until complete clearance or a maximum of six sessions.
Drug: Cholecalciferol (Vit D3)

Cholecalciferol will be administered by intralesional injection into the base of each treated plantar wart using a 27-gauge insulin syringe. The injection volume will be 0.2-0.4 mL per lesion, with a maximum of five warts treated per session. Treatment will be administered weekly until complete clearance or a maximum of six sessions.
Experimental: Intralesional Methotrexate

Twenty participants will receive intralesional methotrexate at a concentration of 25 mg/mL, injected into the base of each plantar wart until blanching occurs. A maximum of five warts will be treated per session. Sessions will take place weekly until complete clearance or a maximum of six sessions.
Drug: Methotrexate

Methotrexate injection, supplied as 50 mg/2 mL and used at a concentration of 25 mg/mL, will be administered into the base of each treated plantar wart using a 27-gauge insulin syringe until blanching occurs. A maximum of five warts will be treated per session. Treatment will be administered weekly until complete clearance or a maximum of six sessions.
Placebo Comparator: Intralesional Saline Placebo

Twenty participants will receive intralesional saline injections into the base of plantar warts. Sessions will take place weekly until complete clearance or a maximum of six sessions.
Drug: Saline Placebo

Saline will be administered as a placebo by intralesional injection into the base of plantar warts using a 27-gauge insulin syringe. Treatment will be administered weekly until complete clearance or a maximum of six sessions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Percentage of Participants Achieving Complete Clearance of Plantar Warts
Time Frame: One month after the final treatment session

Complete response is defined as disappearance of plantar warts with restoration of normal-appearing skin, assessed by clinical and dermoscopic examination. The percentage of participants achieving complete response will be compared among treatment groups.
One month after the final treatment session

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Clinical and Dermoscopic Treatment Response Category
Time Frame: One month after the final treatment session

Treatment response will be classified as complete response (appearance of normal skin), partial response (at least 50% but less than 100% reduction in original wart diameter and/or number), poor response (less than 50% reduction), or no response (no improvement). The distribution of participants across response categories will be compared among treatment groups.
One month after the final treatment session
Change From Baseline in Number of Plantar Warts
Time Frame: Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session

The number of plantar warts will be recorded by clinical examination. Change will be calculated relative to the baseline wart count. A decrease in wart number indicates improvement.
Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session
Change From Baseline in Plantar Wart Diameter
Time Frame: Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session

Wart diameter will be measured using a ruler and compared with baseline measurements. A decrease in diameter indicates improvement.
Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session
Change in Dermoscopic Features of Plantar Warts
Time Frame: Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session

Serial dermoscopic examinations and photographs will assess changes in black dots, red dots, and skin-line patterns within plantar wart lesions relative to baseline.
Baseline, weekly during treatment for up to six sessions, and one month after the final treatment session
Patient Satisfaction With Treatment Outcome
Time Frame: One month after the final treatment session

Participants will categorize their satisfaction with the treatment outcome as not satisfied, slightly satisfied, or highly satisfied. The distribution of responses will be compared among treatment groups.
One month after the final treatment session
Percentage of Participants With Recurrence of Plantar Warts After Complete Clearance
Time Frame: Through 3 months after the final treatment session

Among participants who achieve complete clearance, the percentage with reappearance of plantar warts during post-treatment follow-up will be reported.
Through 3 months after the final treatment session

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Kafrelsheikh University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 1, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 13, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • KFSIRB200-655

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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