RESUMO
Background: Intralesional immunotherapy has been reported to be effective for warts and to show good safety profiles, but this has not yet been systematically studied. Aims: To determine the efficacy and safety of intralesional immunotherapy for treating non-genital warts. Methods: We comprehensively searched the MEDLINE, Embase, Web of Science and Cochrane Library databases from the times of their inception to January 3, 2020. The primary outcome was the rate of complete response of all lesions. The distant complete response rate of warts located in an anatomically different body part and the recurrence rate were also analyzed. Results: A total of 54 prospective studies was ultimately included. The immunotherapeutic agents used were Mycobacterium w vaccine, measles, mumps and rubella vaccine, purified protein derivative, Candida antigen, interferon, bacillus Calmette-Guérin vaccine and others. The pooled rate of complete response among all patients with non-genital warts treated using intralesional immunotherapy was 60.6% (95% confidence interval 54.8–66.5%). The pooled recurrence rate was 2.0% (95% confidence interval, 1.1–2.9%). All reported adverse events were mild and transient. Limitations: The heterogeneity among studies Conclusion: Intralesional immunotherapy is suggested for use in patients with multiple warts, given its promising results, good safety profile and low recurrence rate.
RESUMO
BACKGROUND: Although several methods have been attempted in the treatment of warts, the traditional destructive method may be painful or ineffective and induce disfiguring scars. Therefore, a more tolerable method with fewer drawbacks is needed. OBJECTIVE: We studied the therapeutic effect of intralesional immunotherapy using the Measles, Mumps, and Rubella (MMR) vaccine and factors affecting it in patients with warts. METHODS: A retrospective study was performed in 207 patients with various types of warts, who did not meet the exclusion criteria for treatment and were followed-up from January 2011 to December 2013. Patients with warts were treated at 2-week intervals, and the therapeutic effect was evaluated 1 month after the final treatment. RESULTS: Overall, 123 (59.5%) patients experienced a greater than half reduction in the size and number of warts. In addition, younger patients (under the age of 20) (p=0.008) and those with common warts (including periungual warts) (p=0.02) showed significantly higher treatment responses. All patients complained of transient mild pain during the intralesional injections, but other side effects were rarely observed. Only 3.2% of patients who experienced a complete response had a recurrence more than 6 months after the final treatment. CONCLUSION: We suggest that intralesional immunotherapy with MMR vaccine can be considered as a primary remedy for patients who are sensitive to pain, especially children with multiple lesions, are concerned about serious side effects, or have common warts, and that treatment response will be improved by increasing the number of applications.