Kavya Manjunath, Shashikumar Basavapura Madegowda, Harish Muddanahalli Rajegowda, Shweta Bhadbhade P
Department of Skin and STD, Mandya Institute of Medical Sciences, Mandya, Karnataka, India.
J Cutan Aesthet Surg. 2017 Apr-Jun;10(2):90-94. doi: 10.4103/JCAS.JCAS_82_16.
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.
This study aims to evaluate the safety and efficacy of intralesional Vitamin D3 for the treatment of cutaneous warts.
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.
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.
Lack of control group was the main drawback in our study.
Intralesional Vitamin D3 is safe and effective for treatment of multiple cutaneous warts.
皮肤疣主要采用冷冻疗法或电灼术等破坏性方法进行治疗。这些治疗方式耗时较长，且对于多个疣体可能会导致瘢痕形成。免疫疗法作为一种新的治疗方式正在兴起，其作用机制是增强针对人乳头瘤病毒的细胞介导免疫，以清除已治疗的疣体及远处的疣体。
本研究旨在评估皮损内注射维生素D3治疗皮肤疣的安全性和有效性。
选择患有多个疣体的患者进行免疫治疗。在注射利多卡因（0.2 ml，20 mg/ml）后，将维生素D3（0.2 ml，15 mg/ml）注射到疣体底部。每隔2周重复注射一次，最多进行4次注射，或直至疣体完全清除，以先达到者为准。每次最多治疗2个疣体，末次注射后对患者随访6个月。
42例患有多个疣体的患者被纳入本研究，他们均完成了6个月的随访期且可供分析。其中，23例患有掌跖疣，18例患有寻常疣，1例患有丝状疣。42例患者中，共有33例（78.57%）显示完全缓解，6例（14.28%）显示中度缓解，3例（7.14%）显示轻度缓解。1例掌跖疣患者出现复发。未报告严重不良反应。
缺乏对照组是本研究的主要缺陷。
皮损内注射维生素D3治疗多个皮肤疣安全有效。
