Does immunotherapy of viral warts provide beneficial effects when it is combined with conventional therapy?

Abstract

Background: Cryotherapy has been accepted as the mainstay in treating periunugal and palmoplantar warts. The major drawback of cryotherapy is the requirement of several unbearably painful treatment sessions.

Objective: This study aims to assess the efficacy of immunotherapy in viral wart treatment, as an adjunctive method to cryotherapy.

Methods: Retrospective chart review was performed on 124 patients visiting the hospital from January to December 2009 for the treatment of periungual and plantar warts. We analyzed the number of cryotherapy sessions necessary for treating warts and assessed the clinical benefits from the addition of other treatment modalities, by adjusting the various confounding factors.

Results: Of the 124 investigated patients, immunotherapy with diphenylcyclopropenone (DPCP) was performed in 14 patients (11%), together with cryotherapy. After adjusting the factors related to the therapeutic difficulties of wart, the average number of cryotherapy sessions for the immunotherapy-combined group was significantly lower (3.58±1.25) than that for the cryotherapy only group (5.10±0.44) (p=0.026). However, there were no differences in the number of treatment sessions of cryotherapy when topical 5-FU/salicylic acid agents were added to the treatment.

Conclusion: Immunotherapy may be a successful adjuvant to cryotherapy in reducing the number of agonizing cryotherapy sessions.

Keywords: Cryotherapy; Immunotherapy; Warts.

Fig. 1

The required number of cryotherapy sessions for complete remission of warts. Before adjusting the confounders, patients treated with the combined method paradoxically required more sessions, although the difference was not statistically significant. However, after adjustment, the combined therapy significantly decreased the number of cryotherapy sessions. Data are presented as mean±SEM (^*p<0.05). Statistical significance was determined using the Student's t-test and adjustment was done by ANCOVA. DPCP: diphencyclopropenone.