Topical Calcipotriol for the Treatment of Cutaneous Warts: An Assessor‐Blind Randomized Placebo‐Controlled Trial

Abstract

Background. Cutaneous warts are common epidermal proliferations caused by human papillomavirus (HPV). We aimed to determine the safety and efficacy of topical calcipotriol for the treatment of cutaneous warts. Methods. This assessor-blind randomized placebo-controlled trial included 56 patients with cutaneous warts referred to a dermatology clinic from January 21 to March 20, 2020. Patients were randomized into two groups (n = 28). One group received calcipotriol 0.05% ointment twice a day on the lesions with a uniform thickness of 1 mm, and the other group received a placebo. The duration of treatment was twomonths, which continued for another two months if resolution did not occur. The primary outcome was complete response to treatment evaluated four months after the initiation of therapy. Secondary outcomes were the number and size of warts assessed at 1, 2, and 4 months and adverse events, including erythema, pruritus, burning sensation, and scaling. Results. Patients in both groups were comparable regarding previous treatment, underlying disease, and disease duration. However, patients in the control group were older. Also, a higher proportion of patients in the calcipotriol group were male and had warts on their palms and toes. Moreover, a higher percentage of controls had moderate disease. The mean number and the size of lesions did not differ between groups before intervention; however, both were significantly lower in the calcipotriol group than in controls at 1st, 2nd, and 4th months. In addition, complete response to treatment was significantly higher in the calcipotriol group (85.7% vs. 16%; P < 0.001 ). On the other hand, the frequency of adverse events was not different between groups ( P = 0.352 ). Conclusions. Calcipotriol can be considered a safe and effective treatment option for cutaneous warts. Trial Registration: This trial is registered with IRCT20170818035762N2, available at https://www.irct.ir/trial/45716.

Vitamin D and Skin: An Review and Update

“…Moreover, the calcipotriol group exhibited a significantly higher rate of complete response to treatment. 40 Another study with 42 patients experiencing multiple cutaneous warts demonstrated a complete response in 78.8 percent of patients treated with intralesional vitamin D3. 41 In a study involving 64 patients with recurrent warts, injections of 0.2-0.5 mL at a concentration of 15 mg/ mL were administered at 3-week intervals.…”

“…39 Intralesional vitamin have proven to be both safe and effective, while only a limited number of studies have indicated the effectiveness of applying vitamin D derivatives topically. 40 Imagawa and Suzuki initially achieved success in treating refractory warts in 17 patients using topical vitamin D3 (maxacalcitol). For all of the patients, the warts disappeared.…”