A comparative evaluation of therapeutic efficacy and safety of Falknor’s needling versus autoimplantation in cutaneous warts

Background: Warts, the most common manifestation caused by human papillomaviruses. Treatment is needed because of risk of transmission, cosmetic point of view, multiple, painful, and disfigurement caused by warts. Aims and Objectives: In this study, two techniques of autologous therapy are compared in terms of safety and efficacy. Falknor’s needling and autoimplantation, both are minimally invasive procedures with the aim of treating one wart and inducing immunity against the viral infected cells. Materials and Methods: Forty patients of clinically diagnosed cutaneous warts were randomly divided into two groups. In Group A, Falknor’s needling was performed on a single lesion in each patient. In Group B, autoimplantation was done by harvesting a single lesion and then implanting the tissue in subcutaneous tissue of the patient at other body site. Results: Data were analyzed using SPSS software v. 23 (IBM Statistics, Chicago, USA) and Microsoft Office 2007. Both the modalities showed excellent response (P = 0.504) in the treatment of warts with Grade 4 improvement in 85% (17 patients each) in both the modalities, with 5% of the patients showing Grade 2 and Grade 3 improvement each in needling group. Conclusion: Both the modalities of autologous therapy are simple, easy to perform, safe, and cheap modalities with excellent results in the treatment of cutaneous warts.

Intralesional immunotherapy with killed Mycobacterium indicus pranii vaccine for the treatment of extensive cutaneous warts.

Background: Multiple cutaneous warts in adults are often symptomatic, cosmetically disabling, and difficult to treat. Killed Mycobacterium indicus pranii (previously known as Mycobacterium w, popularly known as Mw) vaccine has earlier been investigated in genital warts with encouraging results. Objective: To evaluate the efficacy and safety profile of intralesional injected killed Mw vaccine for the treatment of extensive extragenital cutaneous warts. Methods: In this study, a retrospective analysis of medical records was performed in patients with cutaneous warts treated with intralesional Mw vaccine. Only patients with more than 5 extra‑genital warts, involving at least two body sites and which had not shown any signs of spontaneous regression over 6 months were treated with the vaccine. Results: Forty four patients were treated with intralesional Mw vaccine. The mean number of warts was 41.5 ± 25.7 with a disease duration of 3.1 ± 2.5 years. Complete clearance was achieved in 24 (54.5%) patients with a mean of 3.4 ± 1.1 intralesional injections. Cosmetically acceptable response to therapy (>75% clearance) was achieved in 37 (84.1%) patients. Wart response at distant sites was seen in 38 (86.3%) patients. Thirty‑six patients (81.8%) experienced mild therapy‑related side effects. Eighteen patients with complete response were followed up for 5.27 ± 1.7 months and none had recurrence of lesions. Conclusions: Killed Mw vaccine is safe and effective in the treatment of extensive cutaneous warts. Larger, preferably randomized controlled trials are needed to assess its efficacy vis a vis standard therapies for warts.

Diagnóstico y terapia del virus papiloma humano / Diagnosis and treatment of human papilloma virus

Tanto el diagnóstico como el tratamiento de la infección producida por el virus papiloma humano y el cáncer asociado a este virus, nos plantean uno de los mayores desafíos en la última década. Las principales dificultades radican en la identificación del genotipo viral, la ausencia de una terapia antiviral efectiva y las altas tasas de recurrencia y persistencia a pesar de la terapia empleada. Se presenta un resumen de la terapia disponible en la actualidad.

The identification and treatment of human papillomavirus (HPV) infections and HPV-associated neoplasm are complex. Difficulties in diagnosis and treatment of HPV-associated diseases arise from inabilities to detect HPV efficiently, the lack of specific antiviral drugs active against HPV and the high rates of recurrence and persistence of HPV infections after treatment. We present a review of therapies for HPV infections.