A comparative study of the efficacy and safety of intralesional measles, mumps, and rubella vaccine versus intralesional vitamin D3 for the treatment of warts in children

Abstract

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.

Evaluation of the Efficacy of Intralesional Measles, Mumps, and Rubella Vaccine with Intralesional Vitamin D3 as Immunotherapies in the Treatment of Recalcitrant Cutaneous Warts in Adult- A Randomized Placebo-Controlled Study

“…Unlike MMR, only a handful of studies have evaluated the efficacy of vitamin D3 for warts with complete response rates ranging from 40% to 90%. [ 12 13 22 23 24 25 26 27 ] Our results are fairly similar with the first published study of intralesional vitamin D3 conducted by Aktaş et al . [ 22 ] who had also reported complete clearance in 80% patients.…”

“…Several studies in the past have compared the response of intralesional vitamin D3 against other immunotherapies like PPD, candida antigen and MMR vaccine. [ 11 12 13 14 25 26 ] In their study Singh et al . [ 25 ] had compared Vitamin D3 with PPD tuberculin and revealed that 72.5% in the former group showed complete response.…”

“…The importance of placebo in any randomized trial like this cannot be overstated. While our previously published study was limited by the absence of same (owing to the ethical considerations in pediatric group),[ 12 ] we made our best efforts to include a control group in this one. Concerning the control group (group C) using saline, complete response was seen only in three (12.5%) patients, partial response in five (20.8%) patients and no response in 19 (66.7%) patients.…”

“…So far, only two studies have compared vitamin D3 with MMR vaccine as immunogens, in which one study was conducted by our group in pediatric patients. [ 12 13 ] However, both studies were limited by the lack of a placebo group. Herein, we are expanding our previously published work in the pediatric patients and present our observation in treating recalcitrant warts in adults.…”

Computational systematics of nutritional support of vaccination against viral and bacterial pathogens as prolegomena to vaccinations against COVID-19

“…In particular, folates, pyridoxine (vitamin B6) and cyanocobalamin (vitamin B12) are required to maintain DNA methylation, making these three vitamins essential for cell division. Folate deficiency is associated with impaired growth of blood cells (including erythrocytes and leukocytes) and impairs the immune response [42]. The influence of folates on lymphocyte growth is responsible for the effects of supplementation of folic acid on vaccination outcomes.…”