Intralesional <i>Candida</i> Antigen Immunotherapy for the Treatment of Recalcitrant and Multiple Warts in Children

Muñoz-Garza, Fania Zamantta; Crespo, Esther Roè; Torres-Pradilla, M.; Peiró, Paula Aguilera; Cruz, Susana Baltà; Ruiz, María Eugenia Hernández; Torres, Eulàlia Baselga

doi:10.1111/pde.12667

Cited by 29 publications

(25 citation statements)

References 14 publications

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“…Immunotherapy is efficacious in pediatric and adult patients, particularly in cases of multiple or recalcitrant warts. Studies of Candida antigen, MMR, and PPD provided comparable complete response rates of injected warts, from 39% to 88% for candida, 26.5% to 92% for MMR, and 23.3% to 94.4% for PPD . However, BCG appears to be an inferior treatment choice, with clearance rates limited at 33.3%‐39.7%,…”

Section: Discussionmentioning

confidence: 94%

“…Injection pain was reduced with pre‐injection cryotherapy. There were few reports of subsequent bullae, edema, desquamation, and fever …”

Section: Resultsmentioning

confidence: 99%

“…Due to reports of distant wart resolution, a systemic immune response resulting from intralesional immunotherapy has been proposed. Majid et al and Munoz et al reported distant wart resolution from Candida antigen at rates of 55.9% and 57.4% . Two studies in which patients received either Candida or mumps antigen did not separate clearance rates by specific immunotherapy treatment; aggregate complete distant wart resolution rates were 34% to 78% .…”

Section: Discussionmentioning

confidence: 98%

“…However, Na et al and Shaheen et al did correlate significantly improved treatment response to MMR and PPD with younger age . Three Candida antigen studies examined exclusively pediatric populations, with complete response rates of 47%, 70.9%, and 87%; the study with a response rate of 47% was a combined rate for patients receiving either candida or mumps . In the studies by Agrawal et al (MMR), Abd‐Elazeim et al (PPD), Munnangi et al (BCG), and Signore et al (candida), age was not a significant factor in terms of treatment outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…Wart location may have an impact on treatment success but was only discussed in one study. Munoz et al concluded warts located on hands and feet responded better to treatment than other body parts . In Johnson et al, most patients treated with intralesional injection of mumps or candida into one lesion had distant wart clearing in all anatomic sites, regardless of distance from injection…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

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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Section: Discussionmentioning

confidence: 94%

“…Injection pain was reduced with pre‐injection cryotherapy. There were few reports of subsequent bullae, edema, desquamation, and fever …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Intralesional immunotherapy for pediatric warts: A review

Fields

Saikaly

Schoch

2020

Pediatric Dermatology

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Laser for Verrucae

Eber

Perper

Verne

et al. 2019

Pediatric Dermatologic Surgery

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The efficacy and safety of intralesional Candida vaccine versus topical diphencyproprobenone in immunotherapy of verruca vulgaris: A randomized comparative study

El-Komy

Shamma²,

Bedair

2022

Arch Dermatol Res

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Various therapeutic options are available for verruca. While physical destruction may be associated with scarring, immunotherapy may be effective in treating warts through stimulating body immune response. The objective of the study was to compare the efficacy, safety, and outcome of Candida antigen vs diphencyprone (DPCP) in the treatment of warts. Fifty patients were randomly assigned to receive either intralesional Candida antigen every 3 weeks or weekly DPCP application. Both treatments were applied only to the mother wart. Lesions’ clearance and associated side effects were observed up to 4 weeks after treatment. Two blinded physicians evaluated photos of warts before and 4 weeks after the end of treatment. Both modalities granted wart clearance and/or improvement with no statistically significant difference; however, Candida antigen was significantly better in clearing adjacent untreated warts (p = 0.046). Fewer side effects were observed among the Candida antigen group. The response was duration associated in the Candida groups only. Intralesional Candida antigen injection and DPCP treatments for warts yielded improvement with superiority of Candida injection in eradicating distant lesions and fewer side effects. A shorter wart duration may be associated with a better therapeutic response with Candida antigen.

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Intralesional Candida Antigen Immunotherapy for the Treatment of Recalcitrant and Multiple Warts in Children

Abstract: Intralesional injection of Candida antigen is an effective and safe therapy for children with multiple and recalcitrant cutaneous warts.

Cited by 29 publications

References 14 publications

Intralesional immunotherapy for pediatric warts: A review

Intralesional immunotherapy for pediatric warts: A review

Laser for Verrucae

The efficacy and safety of intralesional Candida vaccine versus topical diphencyproprobenone in immunotherapy of verruca vulgaris: A randomized comparative study

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