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. 2022 Sep 5;13(5):611-616.
doi: 10.4103/idoj.idoj_39_22. eCollection 2022 Sep-Oct.

A Comparative Analysis of Efficacy of Intralesional Mumps-Measles-Rubella Vaccine Versus 5-Fluorouracil in the Treatment of Palmoplantar Warts

Ansu S Sunny  1 , Bhavana R Doshi  1
Affiliations

A Comparative Analysis of Efficacy of Intralesional Mumps-Measles-Rubella Vaccine Versus 5-Fluorouracil in the Treatment of Palmoplantar Warts

Ansu S Sunny et al. Indian Dermatol Online J. .

Abstract

Background: Palmoplantar warts are quite resistant to treatment, so treating them is a challenge as ablative modalities lead to pain, temporary immobility, secondary infections, and scarring. The treatment of warts using immunotherapeutic methods and cytotoxic methods is being increasingly used to overcome drawbacks in the treatment of warts.

Aim: To evaluate the efficacy and safety of intralesional mumps-measles-rubella (MMR) vaccine versus 5-fluorouracil (5-FU) in the treatment of palmoplantar warts.

Materials and methods: A total of 36 patients were divided into two groups of 18 each, MMR and 5-FU groups, respectively. The patients in the MMR group were given 0.1ml - 0.5ml of intralesional MMR vaccine in each lesion depending on the dimensions of the lesion and was repeated at 2 weekly intervals until complete clearance or a maximum of six doses. The patients in the 5-FU group were given 0.1ml - 0.5ml of intralesional injection of a solution containing 4 mL of 250 mg/mL of 5-FU and 1 mL of a mixture of 20 mg/mL (2%) lidocaine and 0.0125 mg/mL of epinephrine, which was given at 2 weekly intervals until complete clearance or maximum six doses.

Results: In our study, warts had resolved in all 18 (100%) patients belonging to the MMR group by the 12th week, whereas 11 (61.11%) patients still had warts among the patients belonging to the 5-FU group (i.e., warts had resolved only in 7 (38.89%) patients at the end of 12th week), which was found to be statistically significant (P-value < 0.05).

Limitation: Smaller sample size and lack of follow-up to evaluate for possible recurrence.

Conclusion: MMR vaccine is a safe and effective treatment modality for palmoplantar warts compared to 5-FU.

Keywords: 5-FU; MMR; warts.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Shows clinical picture of a patient in the MMR group in a case of plantar warts prior to the treatment. (b) Shows a clinical picture of a patient in the MMR group in a case of plantar warts after evaluating the outcome of previous 3 injections. Some residual warts are seen, a VAS score of 75%–99%
Figure 2
Figure 2
(a) Shows clinical picture of a patient in the MMR group in a case of plantar warts prior to the treatment. (b) shows complete resolution of warts after evaluating the outcome of previous 4 injections of MMR, a VAS score of 100% in the case of plantar warts
Figure 3
Figure 3
(a) Shows clinical picture of a patient in the 5-FU group in a case of subungual warts prior to the treatment. (b) Shows a clinical picture of a patient in the 5-FU group in a case of subungual warts after evaluating the outcome of previous 4 injections, some residual warts were seen. A VAS score of 75%–99%
Figure 4
Figure 4
(a) Shows a clinical picture of a patient in the 5-FU group in a case of mosaic warts prior to the treatment. (b) Shows a clinical picture of a patient in the 5-FU group in a case of mosaic warts after 6 injections, some residual warts are seen, a VAS score of 75%–99%
See this image and copyright information in PMC

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