A Comparative Study of Therapeutic Efficacy of Intralesional Measles, Mumps, and Rubella Vaccine and Intralesional Vitamin D3 in the Treatment of Recurrent Warts

Abstract

Background: Recurrent or resistant warts may be due to defective cell-mediated immune response. Immunotherapy is directed at manipulating the immune system to achieve an anti-human papillomavirus immune reaction. Purpose: Our study compared the safety and efficacy of intralesional measles/mumps/rubella (MMR) vaccine to intralesional Vitamin D3 injection in recurrent warts. Methods: Sixty-six patients were divided into two groups of 33 each. In Group A and B, patients were injected with 0.5 ml of Vitamin D3 and 0.5 ml of MMR vaccine, respectively, intralesionally into the base of the largest wart every 2 weeks until complete clearance or for a maximum of 4 doses. The patients were evaluated for clinical improvement and any adverse effects. Results: Complete clearance of warts was noted in 52% (17) in Group A and in 70% (23) in Group B. Excellent to complete response was noted in 82% (27) in Group A and in 91% (30) in Group B. The clinical improvement noted with intralesional MMR vaccine was not statistically different than with intralesional Vitamin D3 (P > 0.05). Conclusion: Intralesional MMR and Vitamin D3 are promising options for recurrent warts.

Systematic Review of Intralesional Therapies for Cutaneous Warts

“…Wart types most commonly included verruca vulgaris, followed by verruca plantaris and verruca palmaris, and least commonly included verruca plana and periungual warts. Only 4 therapies were trialed in greater than 10 RCTs: these 4 most common therapies were MMR (n = 24), PPD (n = 19), vitamin D (n = 15), and Candida (n = 14) ( Table 3 ) ( Abd-Elazeim et al, 2014 ; Abd El-Magiud et al, 2020 ; Agrawal et al, 2018 ; Ahmed et al, 2020 ; Amin et al, 2021 ; Amirnia et al, 2016 ; Awad et al, 2023 ; Awal and Kaur, 2018 ; Baaniya et al, 2021 ; Bhalala et al, 2021 ; Eldahshan et al, 2022 ; ElGhareeb, 2019 ; El Sayed et al, 2020 ; Elsayed Ghaly et al, 2021 ; Fathy et al, 2019 ; Fawzy et al, 2020 ; Hodeib et al, 2021 ; Ibrahim et al, 2022 , 2020 ; Jain and Marfatia, 2021 ; Jartarkar et al, 2021 ; Kareem et al, 2019 ; Kaur et al, 2021 ; Khozeimeh et al, 2017 ; Khurshid and Pal, 2009 ; Mehta et al, 2021 ; Milante et al, 2019 ; Mohammed et al, 2021 ; Mohta et al, 2022 , 2021 ; Nassar et al, 2022 ; Nofal et al, 2022a , 2022b , 2022c , 2021a , 2021b , 2020b ; Nofal and Nofal, 2010 ; Rageh et al, 2021 ; Rajegowda et al, 2020 ; Rezai et al, 2019 ; Rutnin et al, 2023 ; Shaldoum et al, 2020 ; Wan Ahmad Kammal et al, 2021 ; Zamanian et al, 2014 ; Zainab et al, 2021 ). The most common therapy, MMR, was reported in 807 patients across studies.…”

Comparison of MMR Vaccine V/S 5-Fluorouracil in Treatment of Palmo-plantar Warts

“…Intra-lesional 5-Fluorouracil is destructive therapeutic option for treatment of warts 5 . It is a anti-tumor agent which inhibits synthesis of pyrimidine and thymidine indirectly by blocking DNA synthesis thus resulting in inhibition of cellular proliferation and replication 6,9 .…”