Cimetidine Therapy for Recalcitrant Warts in Adults

Glass, A.; Solomon, Barry A.

doi:10.1001/archderm.1996.03890300108014

Cited by 59 publications

(16 citation statements)

References 21 publications

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“…We returned the results from GenBank on-line BLAST server and revealed that both lesions had HPV type 11 DNA sequence, making a diagnosis of disseminated HPV-11 infection (Fig 4). 8 We treated the skin lesions with surgical excision, electrocauterization, trichloroacetic acid (Kanto Chemical Co, Tokyo, Japan), podophyllotoxin cream (Wartec, Stiefel Laboratories, Sligo, Ireland), and oral cimetidine, 9 but there were only partial effects. The patient expired 14 months later because of sepsis.…”

Section: Case Reportmentioning

confidence: 99%

Disseminated human papillomavirus type 11 infection in a patient with pemphigus vulgaris: Confirmed by DNA analysis

Ko¹,

Chu²

2004

Journal of the American Academy of Dermatology

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Section: Case Reportmentioning

confidence: 99%

Disseminated human papillomavirus type 11 infection in a patient with pemphigus vulgaris: Confirmed by DNA analysis

Ko¹,

Chu²

2004

Journal of the American Academy of Dermatology

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“…At high dose, cimetidine has additional immunomodulatory activities [65][66][67], This led to its use in different condi tions including candidiasis [68], shingles, herpes simplex and also viral warts [69][70][71]. In a controlled study, per formed recently in patients with common warts, however, cimetidine was shown to be no more effective than place bo [72].…”

Section: Cimetidinementioning

confidence: 99%

Therapy of Human Papillomavirus Infection and Associated Epithelial Tumors

Gross

1997

Intervirology

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Papillomavirus infections are very common and cause various benign and malignant lesions, most notably condyloma acuminatum, anogenital cancer, laryngeal papilloma and skin warts. Unfortunately, effective therapy is currently not available. Therapeutic options are limited, expensive and often ineffective. They comprise cytodestructive and cytotoxic substances, surgical methods, laser and cryotherapy. Immunotherapy seems to be one of the more promising options. Interferons combined with ablative methods such as CO2 laser can prevent recurrence of disease. Cytokine enhancement is an old concept that has shown effectiveness with imidazoquinolinamine derivatives (imiquimod). Imiquimod was released recently for therapy of genital warts. Currently, HPV vaccines are being developed to protect against infection with HPV and to treat existing warts and other HPV-associated lesions. Some processes in the HPV infection cycle have been determined as possible targets for the development of specific antiviral agents. Cidofovir is a primordial antiviral substance active against HPV. Unfortunately, there is a potential risk for side effects.

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“…4,6 A cimetidina é um antagonista de receptor H2 e tem efeito imunomodulador, sendo usada em crianças para tratar verrugas; [8][9][10] em adultos, entretanto, o uso de cimetidina no tratamento de verrugas tem resultados conflitantes. 1,5,11,12 Em vista disso, torna-se interessante estabelecer a eficácia terapêutica da cimetidina e do sulfato de zinco nos pacientes com verrugas recalcitrantes e múltiplas.…”

Section: Introductionunclassified

“…Ela tem sido usada com sucesso para estimular o sistema imune de pacientes com imunodeficiências mediadas por células T, como imunodeficiência comum variável, candidíase mucocutâ-nea, 8,17,19 hiperimunoglobulinemia E e herpes-zóster crô-nico em paciente imunocomprometido. 8 Altas doses de cimetidina 30-40mg/kg/dia tem sido relatado como efetivo no tratamento de verrugas recalcitrantes em adultos 12,20 e crianças, 8,19,20 mas outros estudos não têm observado melhores resultados da cimetidina em relação ao placebo. 11,[21][22][23] Neste trabalho o uso da cimetidina para verrugas múltiplas não curou nenhum paciente; três apresentaram diminuição do tamanho, e três diminuição do número das lesões, mas diminuição inferior a 30% das lesões iniciais, com resultados pouco expressivos, não justificando seu uso.…”

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Comparação entre a eficácia da cimetidina e do sulfato de zinco no tratamento de verrugas múltiplas e recalcitrantes

Stefani

Bottino

Fontenelle

et al. 2009

An. Bras. Dermatol.

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INVESTIGAÇÃOResumo: FUNDAMENTOS: Verrugas são proliferações epiteliais na pele e mucosas causadas por diversos tipos de HPV. Elas podem involuir espontaneamente ou aumentar em número e tamanho de acordo com estado imunitário do paciente. A cimetidina e o sulfato de zinco têm importante efeito no sistema imune, sendo usados como imunomoduladores no tratamento de diversas doenças. OBJETIVO: Comparar a eficácia terapêutica de cimetidina e sulfato de zinco no tratamento de verrugas cutâneas de difícil tratamento. MÉTODOS: Estudo prospectivo duplo-cego randomizado. Dezoito pacientes com verrugas múltiplas foram divididos em dois grupos, um recebeu cimetidina 35mg/kg/dia (máximo 1.200mg/dia), e o outro, sulfato de zinco 10mg/kg/dia (máximo de 600mg/dia) por três meses. RESULTADOS: Dos 18 pacientes do estudo, nove receberam cimetidina, e nove, sulfato de zinco; apenas um do grupo do sulfato de zinco não completou o tratamento devido a náuseas e vômitos. Cura foi obtida em cinco pacientes tratados com sulfato de zinco, e apenas um não obteve alteração das lesões. Do grupo da cimetidina cinco não apresentaram modificação, e quatro apresentaram diminuição inferior a 30% das lesões iniciais. CONCLUSÕES: Sulfato de zinco na dose de 10mg/kg/dia parece ser mais efetivo que cimetidina para o tratamento de crianças e adultos com verrugas múltiplas e de difícil manejo. A pequena casuística deste trabalho não permite, entretanto, conclusão categórica. Palavras-chave: Cimetidina; Papillomaviridae; Sulfato de zinco; Verrugas; Verrugas/terapia Abstract: Background: Warts are epithelial proliferations on the skin and mucous membrane caused by various types of HPV. They can decrease spontaneously or increase in number and size according to patient's immune status. Cimetidine and zinc sulphate have important effects on the immune system and are used as immunomodulators in the treatment of various diseases. Objective: To compare the efficacy of cimetidine and zinc sulphate in the treatment of multiple and recalcitrant warts. Methods: A random double-blind prospective study. Eighteen patients with multiple warts were divided into two groups: one took 35mg/Kg/day of cimetidine (maximum 1200 mg/day) and the other 10 mg/Kg/day of zinc sulphate (maximum 600 mg/day) for three months. Results: Among the 18 patients who participated in the study, nine took cimetidine and nine zinc sulphate. Just one patient in the zinc sulphate group did not complete treatment due to nausea and vomiting. Five patients who were treated with zinc sulphate were cured and only one did not show modifications in lesions. Among the group who was treated with cimetidine, five did not show modifications in lesions and four showed decrease from baseline below 30%. Conclusions: 10 mg/Kg/day zinc sulphate dose seems to be more effective than cimetidine for the treatment of children and adults with multiple and difficult-to-handle warts. However, the small number of patients did not enable any definitive conclusion.

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Cimetidine Therapy for Recalcitrant Warts in Adults

Cited by 59 publications

References 21 publications

Disseminated human papillomavirus type 11 infection in a patient with pemphigus vulgaris: Confirmed by DNA analysis

Disseminated human papillomavirus type 11 infection in a patient with pemphigus vulgaris: Confirmed by DNA analysis

Therapy of Human Papillomavirus Infection and Associated Epithelial Tumors

Comparação entre a eficácia da cimetidina e do sulfato de zinco no tratamento de verrugas múltiplas e recalcitrantes

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