Chauhan Pushpinder Singh, Mahajan Vikram K, Mehta Karaninder Singh, Rawat Ritu, Sharma Vikas
Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.
Indian Dermatol Online J. 2019 Jan-Feb;10(1):19-26. doi: 10.4103/idoj.IDOJ_142_18.
Most therapeutic modalities for common warts remain unsatisfactory.
To evaluate efficacy and safety of intralesional MMR (measles, mumps, rubella virus) vaccine in the treatment of common warts in adults.
There were 110 (M:F = 61:49) patients aged 19-62 years having 1-211 warts over dorsal hands, feet, palms, soles, and periungual skin for 1-252 months. MMR vaccine 0.25 mL was injected intralesionally in the largest wart and repeated at 2-week interval until complete clearance or maximum of five doses. The outcome was evaluated as complete clearance, excellent, good, or unsatisfactory response on visual analog scale at every visit and at 4 and 8 weeks, thereafter by comparing baseline clinical photograph. Likert scale was used for patient satisfaction level assessment similarly.
Only 51 patients completed the study and 42 (82.4%) of them showed complete clearance of warts and 9 (17.6%) patients showed good or unsatisfactory response. In 4 (7.8%) patients, the warts subsided completely after one dose itself. The four patients showing excellent response after five doses initially also continued to improve during follow-up period of 8 weeks. Except for injection site pain, no adverse effects were noted. There was no recurrence of warts among cured who were also very much satisfied from treatment.
Despite variable results, intralesional MMR vaccine immunotherapy appears another possible safe and effective treatment option for common warts in a set of adult patients with advantages of regression of distant warts, no significant adverse effects and low recurrence. However, well-designed, controlled studies for minimum effective dose and treatment schedule are highly desirable to make any recommendation.
大多数针对寻常疣的治疗方法仍不尽人意。
评估病灶内注射麻腮风（麻疹、腮腺炎、风疹病毒）疫苗治疗成人寻常疣的疗效和安全性。
110例患者（男:女 = 61:49），年龄19 - 62岁，在手背、足部、手掌、足底及甲周皮肤有1 - 211个疣体，病程1 - 252个月。将0.25 mL麻腮风疫苗注射到最大的疣体病灶内，每2周重复注射一次，直至疣体完全清除或最多注射5剂。每次就诊时以及之后4周和8周，通过视觉模拟量表评估疗效，分为完全清除、优、良或差反应，之后通过比较基线临床照片进行评估。同样使用李克特量表评估患者满意度。
仅51例患者完成研究，其中42例（82.4%）疣体完全清除，9例（17.6%）患者反应良好或差。4例（7.8%）患者注射1剂后疣体即完全消退。最初5剂后显示优反应的4例患者在8周随访期内也持续改善。除注射部位疼痛外，未观察到不良反应。治愈患者中无疣体复发，且对治疗非常满意。
尽管结果存在差异，但病灶内注射麻腮风疫苗免疫疗法似乎是一组成年寻常疣患者另一种可能安全有效的治疗选择，具有远处疣体消退、无明显不良反应和低复发率的优点。然而，非常需要进行精心设计的对照研究以确定最小有效剂量和治疗方案，以便做出任何推荐。
