Systemic treatments for cutaneous warts: a systematic review.

BACKGROUND

Systemic therapies are routinely used for the management of cutaneous warts. However, there is a lack of evidence-based data on their effectiveness.

OBJECTIVE

To assess the evidence for the efficacy of systemic treatments for cutaneous warts.

METHODS

We designed a systematic review of the randomized controlled clinical trials (1962 to April 2010) investigating systemic therapies for the treatment of cutaneous warts. We obtained data from MEDLINE, PubMed, Current Contents, reference lists, and specialist textbooks, with no restriction on language. The main outcome measures were the total clearance of warts and the adverse effects.

RESULTS

There was substantial heterogeneity in the design of the trials. No consistent evidence was found for the efficacy of cimetidine, levamisole or homeopathy, and only limited evidence was found for the efficacy of zinc.

CONCLUSIONS

Reviewed trials of systemic treatments for cutaneous warts were highly variable in methods and quality, and there was a paucity of evidence from randomized, placebo-controlled trials on which to base the rational use of such therapies. Limited evidence is emerging that zinc may be effective in selected populations with zinc deficiency.