Pulsed-dye laser versus intralesional Candida albicans

Abstract

Introduction: Genital warts are a troublesome therapeutic issue. Pulsed-dye laser (PDL) is a non-ablative therapeutic tool for viral warts. Intralesional Candida albicans (C. albicans) immunotherapy has yielded promising results in treatment of various types of warts. We aimed to evaluate the effectiveness of PDL versus C. albicans immunotherapy for treatment of genital warts. Methods: Forty adult patients with genital warts were divided into two equal groups; the first was treated using PDL and the second using intralesional C. albicans antigen injection. Treatments were performed at 3-week intervals until complete lesion resolution or for a maximum of three sessions. Results: PDL yielded higher complete clearance rates (95%) than C. albicans antigen (50%; p = 0.001), which in turn had the advantage of treating distant and internal genital warts. Apart from pain during the session in PDL, both modalities were well tolerated with no recurrence in cured patients during the 16-week follow-up period. Conclusions: PDL and C. albicans antigen injection are safe and effective treatment alternatives for genital warts. PDL yielded better frequencies of clearance, but C. albicans antigen has additional advantages, including a single injection site and treating distant and internal mucosal uninjected warts, which are usually difficult to treat.

Intralesional bivalent and quadrivalent human papillomavirus vaccines didn’t significantly enhance the response of multiple anogenital warts when co-administered with intralesional Candida antigen immunotherapy. A randomized controlled trial

“…Marei et al [ 10 ] reported a similar rate of complete clearance of recalcitrant warts in 40% of 20 patients (including 12 patients with genital warts) following intralesional Candida antigen. On the contrary, our results were slightly lower than those reported by Elmaadawy et al [ 6 ], who observed a complete clearance rate of 50% in 20 patients with AGWs after intralesional Candida antigen. This slight variation could be attributed to the longer interval in their study (every 3 weeks) than in our study (every 2 weeks), which could impact the immunological response.…”

“…There was no statistically significant difference between the studied groups. Similar side effects were reported in previous studies [ 6 , 7 , 10 , 21 , 25 ].…”

“…During the 3-month follow-up period, no recurrence was detected among patients with complete or partial response. Similarly, other studies have reported no recurrence in patients who had received Candida antigen [ 6 ], HPV vaccines [ 21 , 23 , 24 ], or both [ 10 ].…”

Efficacy of Intralesional Candida Antigen Versus Measles, Mumps, and Rubella Vaccine Versus Topical Podophyllin in Treatment of Resistant Genital Warts

“…Our results were much better than those obtained by Elmaadawy et al that compared pulsed dye laser versus intralesional C. albicans antigen in the treatment of genital warts with excellent improvement in 10 patients (50%), moderate improvement in 1 patient (5%), mild improvement in 2 patients (10%), poor or no improvement in 7 patients (35%). 9 Comparable results were obtained by Nofal et al, they had compared intralesional Candida antigen versus intralesional tuberculin in treatment of recalcitrant genital warts where complete clearance of genital warts was observed in 12 patients (41.3%) in Candida group. 13 Also comparable results was obtained by Tawfik et al, they compared intralesional injection of purified protein derivative versus Candida antigen in treatment of genital warts where complete clinical response was observed in 25 (62.5%) patients and partial response in 9 (22.5%) patients.…”

“…8 Intralesional injection of immunotherapies such as Candida antigen and measles, mumps, and rubella (MMR) vaccine is a promising modality for recurrent or resistant warts. 9 Candida antigen was used in treatment of genital warts in 4 studies (Elmaadawy et To the best of our knowledge, our study was the first to compare between the efficacy and safety of treating recurrent and resistant anogenital warts using intralesional Candida antigen, intralesional MMR vaccine, and topical podophyllin.…”