Background: Intralesional vitamin D3 has recently emerged as a new treatment for cutaneous warts. The use of the measles, mumps, and rubella (MMR) vaccine for this purpose is an established modality. However, relevant data on the efficacy of either the MMR vaccine or vitamin D3 as immunotherapy for cutaneous warts in the pediatric population are limited. Objectives: To compare the efficacy and safety of intralesional injections of MMR vaccine to intralesional injections of vitamin D3 in children aged 8-16 years with multiple warts. Methods: A total of 74 children were randomly allocated into two groups. Group A patients received intralesional MMR vaccine into the largest wart, and group B received intralesional vitamin D3 into the largest wart. The injections were repeated every 4 weeks until clearance or for a maximum of three treatments. After the last injection, children were followed up every 2 weeks for 3 months, and at the sixth month, a final clinical assessment was conducted. Results: Of 74 children, 60 completed the study, with 30 children in each group. Complete clearance of the injected wart was observed in 26 (86.67%) patients in the MMR group (group A) and 23 (76.7%) patients in the vitamin D3 group (group B). Distant warts cleared in 23 (76.7%) patients in group A compared to 20 (66.6%) patients in group B. There was no significant difference between groups. No recurrence was seen in group A, whereas two (6.6%) children in group B exhibited recurrence in the ensuing 6-month follow-up. The most common adverse events were injection site pain and swelling. Conclusion: Both intralesional MMR and vitamin D3 are safe, generally well-tolerated, and equally effective in children for the treatment of cutaneous warts.

Introduction: Currently, various destructive and ablative treatment options are conventionally used for warts, but all of them are limited in some form by their adverse effects, high recurrences, suboptimal effectiveness, and the need to treat every wart. Lately, immunotherapy has emerged as a safe treatment relying on biological substances that modulate the immune system to achieve disease control. Aims and Objectives: We aimed at conducting a placebo-controlled study to compare the rate of efficacy of intralesional MMR vaccine with vitamin D3 in the management of recalcitrant extragenital warts in immune-competent adults. Follow-up was done at third and sixth month. Materials and Methods: Patients were divided into three groups, namely, group A, B, and C. Groups A, B, and C received intralesional MMR vaccine, vitamin D3 and normal saline, respectively, in the largest wart. The injections were repeated every 2 weeks, for a maximum of four injections. Results: Among injected warts, in group A, complete clearance was seen in 29 (87.8%) patients, partial clearance in two (6.1%) and no response in two (6.1%) patients. In group B, 24 (77.4%) patients, five (16.1%) patients, and two (6.5%) patients showed signs of complete, partial, and no clearance, respectively, in injected warts. Complete response in distant warts was seen in 25 (75.7%) patients in group A and 20 (64.5%) patients in group B. There was no statistically significant difference between responses of the two groups. In group C, only three (12.5%) patients had complete clearance in injected warts, and none in distant warts. Recurrence was seen in two (6.4%) patients, each in group B and C. However, for management of verruca plana MMR was found to be superior to vitamin D3. Limitations: Our study was limited by a small sample size, absence of immunological analysis, and limited follow-up period. Conclusion: MMR vaccine and vitamin D3 are equally effective and safe treatment option for multiple, recalcitrant warts, as well as warts on difficult to treat sites with minimal recurrence.

Background: Extra-genital warts (EGWs) affect 7-10% of population. Even though a plethora of studies have been conducted to assess the impact of genital warts (GWs) showing a significant impact on the quality of life but surprisingly, barely any data has been collected on the impact of EGWs on quality of life. Aims and Objective: This cross-sectional study aimed at comparing the magnitude of EGWs on health-related quality of life and various variables with that of GWs. Patients and Methods: The study consisted of two groups of immunocompetent adults, each with 100 patients aged 18 years or above, attending the skin outpatient department at our tertiary center between April 2018 and March 2019 and consented to participate. Group A consisted of patients with EGWs and group B comprised of patients with GWs. All patients were asked to fulfill the validated Hindi hard copy of the Dermatology Life Quality Index (DLQI) questionnaire. Results: The mean DLQI score of patients with EGWs was 8.73 ± 0.84 and that of patients with GWs was 5.83 ± 0.83 ( P = 0.026). In group A, those affected the most were patients with warts on multiple exposed sites (mean DLQI score of 14), followed by warts on feet (mean DLQI score of 10.69), followed by warts on hands (DLQI score of 9.12), and facial warts (DLQI score of 6.80). Patients with a prior history of failed treatment and/or a longer duration of illness had a higher level of dissatisfaction. To the best of our knowledge, no such study has been conducted in the past in our country. Conclusions: EGWs inflict a severe negative impact on the quality of life. Owing to its notorious persistence and recurrence, healthcare professionals must educate patients on how to prevent the spread and recurrence, discuss details of available treatment modalities while keeping in view the psychological and sociological impact.

Introduction: Rosacea is a chronic skin disease associated with high levels of psychological distress and a significant impact on quality of life. Objective: To evaluate the quality of life, depression and anxiety in patients with rosacea. Material and Methods- Seventy-three patients, aged 18 years or above, with a clinical diagnosis of rosacea were included in the study. All patients completed a Dermatology Life Quality Index (DLQI) questionnaire and a Hospital Anxiety and Depression Scale (HADS) quessionaire. Results: The mean DLQI score of patients was 7.98 ± 5.86 which signified a moderate impact on quality of life. The mean HADS-A (anxiety) score was 4.83 ± 4.42, while the mean HADS-D (depression) score was 5.22 ± 4.04. Thirteen (17.81%) patients had anxiety HADS-A (≥11 points) while 11 (15.07%) patients had depression HADS-D (≥11 points). Total DLQI score of patients with rosacea correlated positively with anxiety (r = 0.67, p value- <0.001) and depression (r = 0.49, p value- <0.001) Conclusion: Rosacea is a distressing disease which has a moderate impact on patient’s QOL. Dermatologists must always be vigilant of the psychosocial aspects of rosacea and should opt for the self-perception of rosacea by patients while prescribing a treatment regimen. Keywords: Rosacea, dermatology life quality index, DLQI, Hospital Anxiety and Depression Scale, HADS

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