An aberrant reaction to  Candida albicans  antigen used for recalcitrant warts successfully treated with oral prednisone

La'Pelusa, Andrew; Rorex, Jennifer N.; Weir, Nathan M.; Travers, Jeffrey B.

doi:10.1016/j.jdcr.2018.01.010

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…The volume of tuberculin administered might be too much in the enclosed space of the finger that was further restricted by the nail plate. Similar complication of painful, purple finger post immunotherapy with Candida antigen has been reported 20,22 . To the best of our knowledge, there are no other reports on compartment syndrome‐like reactions following tuberculin immunotherapy in the literature.…”

Section: Discussionsupporting

confidence: 74%

Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: An assessor‐blinded, randomized controlled trial

Kammal

Jamil

Nor

2021

Dermatologic Therapy

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Cryotherapy is a standard treatment for warts. Tuberculin immunotherapy is a novel therapeutic option. We compared the efficacy and safety of cryotherapy versus tuberculin immunotherapy in a randomized, assessor‐blinded study. 15 patients were treated with intralesional tuberculin and 15 patients received cryotherapy every 2 weeks until complete wart resolution or a maximum of six sessions. Wart diameter, total number of warts and adverse effects were documented. Complete clearance of treated warts was achieved in 13(86.7%) and 11(73.3%) of patients with immunotherapy and cryotherapy respectively. Immunotherapy showed greater wart size reduction (51.88 ± 89.36 mm) than cryotherapy (32.99 ± 36.19 mm), (p = 0.46). Immunotherapy resulted in 64% reduction in total number of warts compared to 23.2% with cryotherapy, p < 0.01. More blisters developed with cryotherapy (46.7%) than immunotherapy (6.7%), (p = 0.01). Compartment syndrome‐like features complicate immunotherapy in 1 patient. Tuberculin immunotherapy and cryotherapy are equally effective in treating warts. Immunotherapy has added benefit with resolution of distant warts. Safety profiles were similar except for blisters which were more common with cryotherapy.

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Section: Discussionsupporting

confidence: 74%

Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: An assessor‐blinded, randomized controlled trial

Kammal

Jamil

Nor

2021

Dermatologic Therapy

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“…There was no significant difference in the adverse effects between the 3 studied groups. We have not observed any of the very rarely reported adverse effects of intralesional antigen immunotherapy, especially with Candida antigen, such as painful purple digits 24,25 or uveitis 26 or those reported with intralesional injection of cytotoxic drugs (eg, bleomycin) such as onychodystrophy. 27 An important concern for both patients and physicians is the fear of injection at this difficult site, especially in children.…”

Section: Discussionmentioning

confidence: 58%

Intralesional Antigen Immunotherapy in the Treatment of Periungual Warts

et al. 2021

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Background Intralesional immunotherapy using different types of antigens is considered an effective and safe treatment option for different types of warts. However, there are few studies that illustrate the use of these antigens in the treatment of periungual warts as a distinct type of warts. Objective To evaluate the efficacy and safety of three antigens: measles, mumps, rubella (MMR) vaccine, Candida antigen, and purified protein derivative (PPD) in the treatment of periungual warts. Methods The study included 150 patients who were randomly assigned to 3 groups with 50 patients in each. Each agent was injected intralesionally at a dose of 0.1 mL into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions. Results Complete clearance of warts was observed in 70%, 80%, and 74% in PPD, Candida antigen, and MMR vaccine groups, respectively. There was no statistically significant difference regarding the therapeutic response between the 3 studied groups. Adverse effects were transient and insignificant in the 3 groups. No recurrence of the lesions was reported in any of the studied groups. Conclusions Intralesional antigen immunotherapy seems to be an effective therapeutic option for the treatment of periungual warts.

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“…In the Candida antigen studies, there were some reports of pruritus, edema, blistering, fever, and myalgia; however, most studies reported no severe or serious reactions . Case reports of rare side effects following Candida antigen injection have included lymphangitis, vitiligo, and uveitis, as well as painful digits . Interestingly, there has also been report of nevi regressing following Candida antigen injection …”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18] Case reports of rare side effects following Candida antigen injection have included lymphangitis, vitiligo, and uveitis, [33][34][35] as well as painful digits. 36,37 Interestingly, there has also been report of nevi regressing following Candida antigen injection. 38 In our review, there were reports of pruritus, flu-like symptoms, and erythema resulting from MMR injection in some studies; however, no adverse effects were noted in other studies.…”

Section: Posed Majid Et Al and Munoz Et Al Reported Distant Wart Resmentioning

confidence: 99%

Intralesional immunotherapy for pediatric warts: A review

Fields

Saikaly

Schoch

2020

Pediatric Dermatology

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Cutaneous warts are a common pediatric complaint with modest response to first‐line treatments. Warts are a manifestation of human papillomavirus (HPV) infection and are cleared by cell‐mediated immunity (CMI). Intralesional immunotherapy treatments have been studied as alternative therapies, particularly for recalcitrant or multiple warts, including Candida antigen, mumps antigen, the combined measles, mumps, and rubella (MMR) vaccine, tuberculin purified protein derivative (PPD), and bacille Calmette‐Guerin (BCG) vaccine. These treatments are thought to increase HPV recognition by stimulating CMI. In this review, we evaluate and compare the efficacy and adverse effects of intralesional immunotherapy in the treatment of pediatric warts. Articles met inclusion criteria if they specifically evaluated the effects of intralesional immunotherapy (candida, MMR, tuberculin PPD, or BCG) as treatment for cutaneous warts in a pediatric population, and if they quantified treatment effect in a reproducible manner. Twenty‐one studies met criteria. Many studies demonstrated complete clearance of injected common warts in pediatric patients with clearance rates ranging from 23.3% to 95.2%. Distant wart resolution was common. Intralesional immunotherapy is a promising treatment option for cutaneous warts in children.

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An aberrant reaction to Candida albicans antigen used for recalcitrant warts successfully treated with oral prednisone

Cited by 8 publications

References 5 publications

Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: An assessor‐blinded, randomized controlled trial

Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: An assessor‐blinded, randomized controlled trial

Intralesional Antigen Immunotherapy in the Treatment of Periungual Warts

Intralesional immunotherapy for pediatric warts: A review

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