Safety and Efficacy of Intralesional Vitamin D3 in Cutaneous Warts: An Open Uncontrolled Trial

Manjunath Kavya, Basavapura Madegowda Shashikumar, Muddanahalli Rajegowda Harish, Bhadbhade P Shweta, Manjunath Kavya, Basavapura Madegowda Shashikumar, Muddanahalli Rajegowda Harish, Bhadbhade P Shweta

Abstract

Background: Cutaneous warts are treated primarily with destructive methods such as cryotherapy or electrocautery. 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 which acts on enhancing cell-mediated immunity against human papillomavirus for clearance of both treated and distant warts.

Aims: This study aims to evaluate the safety and efficacy of intralesional Vitamin D3 for the treatment of cutaneous warts.

Materials and methods: Patients with multiple warts were selected for immunotherapy. Vitamin D3 (0.2 ml, 15 mg/ml) was injected to the base of warts after injecting with lignocaine (0.2 ml, 20 mg/ml). The injections were repeated 2 weeks apart for a maximum of 4 sessions or until complete clearance, whichever was earlier. A maximum of 2 warts were treated per session and patients were followed up for 6 months after the last injection.

Results: Forty-two patients with multiple warts were recruited for the study who completed the 6-month follow-up period and were available for analysis. Of these, 23 had palmoplantar warts, 18 had verruca vulgaris and 1 patient had filiform wart. In total, 33 of 42 patients (78.57%) showed complete response, 6 patients (14.28%) showed moderate response and three patients (7.14%) showed mild response. Recurrence was observed in one patient with the palmoplantar wart. No serious adverse effects were reported.

Limitations: Lack of control group was the main drawback in our study.

Conclusion: Intralesional Vitamin D3 is safe and effective for treatment of multiple cutaneous warts.

Keywords: Cutaneous warts; Vitamin D3; intralesional treatment.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Multiple palmar warts before treatment. (b) Complete clearance after three injections
Figure 2
Figure 2
(a) Verruca vulgaris before treatment. (b) Complete clearance after two injections
Figure 3
Figure 3
(a) Verruca vulgaris before treatment. (b) Complete clearance after two injections
Figure 4
Figure 4
(a) Palmar and periungual wart before treatment. (b) Complete clearance after four injections
Figure 5
Figure 5
Swelling at the injection site
Figure 6
Figure 6
Pigmentation after clearance

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