Department of Dermatology & Venereology, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
Department of Dermatology, Adesh Institute of Medical Sciences & Research, Bathinda, Punjab, India.
Int J Dermatol. 2017 Dec;56(12):1352-1358. doi: 10.1111/ijd.13727. Epub 2017 Sep 13.
Plane warts are a common therapeutic problem. Our aim was to assess the efficacy and safety of oral versus topical isotretinoin in the treatment of plane warts.
Forty patients with multiple plane warts were randomized into two groups. Group A was treated with oral isotretinoin capsules in the dose of 0.5 mg/kg/d and Group B with topical isotretinoin 0.05% in gel formulation once daily at night. Treatment was given to the patients for 3 months or until the complete clearance of lesions, whichever was earlier. Patients with complete response were followed up monthly for 4 months to record the relapse rate.
Results were analyzed in 16 patients of Group A and 13 patients of Group B. At the end of 3 months of therapy, 11 (69%) patients in Group A had complete remission whereas five (31%) had partial remission. In Group B, at the end of study, five (38%) patients had complete remission and six (46%) had partial remission, whereas two patients had no remission. The difference was statistically significant between two groups; P < 0.0001. The most common side effect in Group A was cheilitis. In Group B, five patients had to be dropped because they developed severe erythema and scaling.
Oral isotretinoin showed better and earlier response than topical isotretinoin. Oral isotretinoin should definitely be given a trial particularly in cases of multiple facial warts before trying various destructive procedures.
扁平疣是一种常见的治疗问题。我们的目的是评估口服和局部异维 A 酸治疗扁平疣的疗效和安全性。
将 40 例多发性扁平疣患者随机分为两组。A 组口服异维 A 酸胶囊，剂量为 0.5mg/kg/d；B 组每晚外用异维 A 酸 0.05%凝胶。治疗时间为 3 个月或直至皮损完全清除，以先到者为准。完全缓解的患者每月随访 4 个月，记录复发率。
对 A 组 16 例和 B 组 13 例患者进行了分析。治疗 3 个月后，A 组 11 例（69%）患者完全缓解，5 例（31%）患者部分缓解。B 组研究结束时，5 例（38%）患者完全缓解，6 例（46%）患者部分缓解，2 例患者无缓解。两组间差异有统计学意义；P < 0.0001。A 组最常见的不良反应是唇炎。B 组 5 例患者因出现严重红斑和脱屑而退出。
口服异维 A 酸的疗效优于局部异维 A 酸，且起效更早。在尝试各种破坏性治疗方法之前，特别是对于多发性面部扁平疣患者，应首选口服异维 A 酸。
