Varghese Angel, George Nithin M, Wadhwa Shivani
Department of Dermatology, Fakeeh University Hospital, Dubai, ARE.
Department of Dermatology, West China School of Medicine, Sichuan University, Sichuan, CHN.
Cureus. 2024 Aug 19;16(8):e67225. doi: 10.7759/cureus.67225. eCollection 2024 Aug.
Warts are a prevalent skin condition that can affect people of any age. They are caused by the human papillomavirus (HPV), a double-stranded DNA virus that can cause benign and malignant lesions and remains latent in the host cells, leading to recurrences. Although warts are benign and spontaneous clearance has been reported over the years, they often cause disfigurement, tend to koebnerize, and can be transmitted to others, making adequate and timely treatment important. Several conventional treatments are available, but none works consistently for all patients. Incomplete responses or recurrences are often bothersome to both patients and dermatologists. Moreover, these treatments are often painful, time-consuming, and can cause significant scarring. Immunotherapy, as an alternative, has found a significant place in the treatment of warts because of its non-destructive action, ease of use, and promising results. This paper will discuss a healthy 36-year-old Bosnian male with chronic palmoplantar and periungual warts. Despite undergoing multiple destructive and topical treatments, including electrocautery, cryotherapy, carbon dioxide laser, salicylic acid, glycolic acid, 5-fluorouracil, and imiquimod, he could not achieve significant improvement in his skin condition. Subsequent treatment with the intralesional measles, mumps, rubella (MMR) vaccine also showed little improvement during treatment. However, three months without further treatment, the patient reported complete resolution of the warts. Follow-up confirmed the clearance with no recurrence and minor post-inflammatory hypopigmentation. Our patient's delayed response to the MMR vaccine aligns with findings from other studies indicating that the body's immune response may take time to manifest fully.
疣是一种常见的皮肤疾病，可影响任何年龄段的人。它们由人乳头瘤病毒（HPV）引起，这是一种双链DNA病毒，可导致良性和恶性病变，并在宿主细胞中保持潜伏状态，从而导致复发。尽管疣是良性的，多年来也有自发消退的报道，但它们常常会导致容貌受损，易于同形反应，并且可以传染给他人，因此充分及时的治疗很重要。有几种传统治疗方法，但没有一种对所有患者都能始终有效。治疗反应不完全或复发常常给患者和皮肤科医生都带来困扰。此外，这些治疗通常很痛苦，耗时且可能导致明显的疤痕。免疫疗法作为一种替代方法，因其非破坏性作用、使用方便和效果良好，在疣的治疗中占据了重要地位。本文将讨论一名健康的36岁波斯尼亚男性，他患有慢性掌跖疣和甲周疣。尽管接受了多种破坏性和局部治疗，包括电灼、冷冻疗法、二氧化碳激光、水杨酸、乙醇酸、5-氟尿嘧啶和咪喹莫特，但他的皮肤状况并未得到明显改善。随后采用皮损内注射麻疹、腮腺炎、风疹（MMR）疫苗治疗，在治疗期间也几乎没有改善。然而，在未进行进一步治疗的三个月后，患者报告疣已完全消退。随访证实疣体已清除，无复发，且有轻微的炎症后色素减退。我们的患者对MMR疫苗的延迟反应与其他研究结果一致，表明身体的免疫反应可能需要时间才能充分显现。
