The efficacy of intralesional vitamin D3 injection in the treatment of cutaneous warts: A clinical therapeutic trial study

Abstract

Background: The human papillomavirus that causes warts is usually harmless, and it can infect any part of the skin or mucous membranes. Despite the availability of several treatments, warts often return, and scarring, pigmentation changes, and recurrence are all possible side effects.

Aim: Intralesional vitamin D3 was employed as an immunotherapy for cutaneous warts in the current investigation.

Materials and methods: In Al-Sadr Medical City in the city of Al-Najaf Al-Ashraf, a skin clinic conducted a therapeutic clinical experiment. A total of 204 cutaneous warts were examined in 40 patients (14 men and 26 females). Vitamin D3 solution of the dose (600 000 IU) was injected into the lesions' bases, with 0.2 mL per patient. Each session could only inject up to five warts. The injections were given every 2 weeks for a total of four times. Instructing patients to forego the use of any topical or oral medication was also a part of the protocol. Each patient was evaluated for recurrence risk before each therapy and then again 6 months later.

Result and discussion: There was a wide range of patient ages in this study, from 20 months to 52 years. About 65% of the cases included females. When looking at the many kinds of warts, the most prevalent was the common wart (71.6%). After four treatments, a positive response was considered to have occurred when all lesions had disappeared, a partial response when more than half of the lesions had disappeared, and no reaction when less than half of the lesions had disappeared. The final tally was 81.9% for those who responded in whole, 11.3% for those who responded partially, and 6.9% for those who did not respond at all. Next-session complete response rates were 12.7%, 29.9%, 54.9%, and 81.9%, respectively. Thirteen people experienced adverse symptoms, most noticeably minor swelling and itching. Within 6 months of follow-up, warts had completely disappeared for all patients with a partial or modest response except one who had no reaction.

Conclusion: Vitamin D3 administered intralesional is an effective and low-cost treatment for cutaneous warts.

Keywords: vitamin D; wart.

FIGURE 1

Vitamin D3 ampoules (600 000 IU).

FIGURE 2

Pie‐chart showing the gender distribution and male to female ratio of 40 patients with cutaneous warts.

FIGURE 3

Proportional distribution of 204 warts of the 40 patients with cutaneous warts.

FIGURE 4

Box‐plot showing the change in mean wart size across subsequent treatment sessions. A highly significant reduction in mean size was found (p value <0.001).

FIGURE 5

Comparison of mean size of warts across the response to treatment.

FIGURE 6

Comparison of mean duration of warts across the response to treatment.

FIGURE 7

A boy of 20 years old with single plantar wart in left foot for 10 months shows a complete clearance of wart: (a) before treatment, (b) 2 months after four treatment sessions.

FIGURE 8

A girl of 9 years old with single wart in left third periungual for 1 year shows complete clearance: (a) before treatment, (b) 1 month after two treatment sessions.

FIGURE 9

A girl of 20 years old with multiple common warts in hand shows complete response: (a) before treatment, (b) 6 weeks after three treatment sessions.

FIGURE 10

Women 38 years old with multiple warts in left dorsal foot show complete clearance: (a) before treatment, (b) 2 months after four treatment sessions.