ABSTRACT
Background: In spite of the availability of multiple treatment options, viral warts are known for their persistence and recurrence, causing frustration to patients and treating physicians. Aims: To study the effectiveness and safety of autoinoculation as a treatment modality in cutaneous warts. Methods: A double‑blind, placebo‑controlled study was carried out. In the treatment group, full‑thickness warty tissue was excised, minced and implanted in a small dermal pocket. In the control group, warty tissue was only excised and not implanted, though a dermal pocket was made. Patients were evaluated every four weeks with lesion counts. The procedure was repeated at 4 and 8 weeks. Response was assessed at each visit and at 12 weeks. Results: Forty‑eight patients with cutaneous warts (male: female = 32:16) were randomized into autoinoculation and control groups. The number of warts at baseline was comparable in both groups (P = 0.293). Reduction in the number of warts was significantly more in the autoinoculation group (8.50 ± 13.88) than in the control group (10.04 ± 5.80) from 8 weeks onwards (P = 0.010). Complete resolution occurred only in the autoinoculation group, in 62.5% of cases. Adverse effects were seen in 11 patients, including infection of the donor site (5 cases), keloid formation (3) and hypopigmentation (3). Conclusion: Autoinoculation may be an effective therapeutic modality for cutaneous warts and two sessions may be required for optimum results.
Subject(s)
Adult , Combined Modality Therapy/methods , Female , Humans , Male , Placebos , Randomized Controlled Trials as Topic , Skin Diseases/therapy , Vaccination/methods , Warts/therapyABSTRACT
BACKGROUND: Warts are caused by human papilloma viruses (HPVs) infection. Clinically, warts sometimes may be persistent and are recalcitrant to treatments for months or even years. OBJECTIVE: To investigate the relationship between clinical findings, HPV infection and L1 capsid protein. METHODS: Fifty-six samples from patients with cutaneous warts were used in this study. HPV DNA chip analysis and polymerase chain reaction (PCR) were performed for detecting the HPV types. Immunohistochemical stains were done for detecting the expressions of HPV L1 capsid protein. RESULTS: We found different types of HPV infection in warts, as follows; 17 cases of HPV2, 15 cases of HPV27, 8 cases of HPV1, 7 cases of HPV16, 6 cases of HPV4, 5 cases of HPV5, 5 cases of HPV6, 4 cases of HPV11, 3 cases of HPV3 and 3 cases of HPV10. Infection with only one HPV type was identified in 50.0% (28/56) of the investigated samples, whereas concomitant infection with two and three viral types was present in 19.6% (11/56) and 10.7% (6/56) of the cases, respectively. The incidence of concomitant HPV infections found in common warts was significantly more frequent than other clinical types of cutaneous warts. L1 capsid protein was expressed in all of the cutaneous warts. CONCLUSION: Concomitant HPV infections are common in cutaneous warts especially, common warts though the L1 capsid protein were present in all four clinical types. Further studies should be performed to clarify the relationship of recalcitrant to treatment and concomitant HPV infections in cutaneous warts.