Intralesional (IL) vitamin D3 is an emerging treatment for cutaneous warts. However, its effectiveness and exact mechanism is not fully evaluated. We aimed to compare the efficacy and safety of IL purified protein derivative (PPD) and IL vitamin D3 in multiple warts and to investigate their systemic effect clinically and immunologically. Forty‐five patients with multiple extragenital warts were treated with IL‐PPD (22 patients) or IL vitamin D3 injection (23 patients) for a maximum of three sessions at 3 week intervals. Decrease in size and number of warts and adverse effects were evaluated. Serum interleukin‐12 (IL‐12) and interferon‐gamma (IFN‐γ) levels were measured before and 3 weeks after the last session. Higher clearance rates for all warts were observed with IL‐PPD compared to IL vitamin D (59.1% vs. 21.7% complete clearance, p < .001). Significant increase was found in both serum IL‐12 and IFN‐γ after PPD treatment (p = .034 and p = .04, respectively), but only IFN‐γ after vitamin D3 treatment (p = 0.02). Both IL vitamin D3 and PPD showed positive results in treatment of multiple warts. However, PPD showed higher clinical efficacy and more increase in both IL‐12 and IFN‐γ levels.

Keloid is a proliferative lesion of the connective tissue of dermis that extends beyond the original defect and developed due to an exaggerated response to cutaneous trauma in individuals with a genetic predisposition, which usually does not resolve spontaneously, and there is a tendency to recur after excision. 1 Keloids usually arise following wounds or injuries but they may arise also without any trauma which is termed as spontaneous keloids. 2 They are often considered frustrating cosmetic problems and can cause cosmetic disfigurement, itching, pain, and psychological disturbance and, also, may affect the movement of joints and significantly diminish the quality of life. 3 Several therapies are available for keloids such as mechanical compression dressing, silicone sheet applications, intralesional injection of corticosteroid (triamcinolone acetonide), 5-Fluorouracil, interferon or bleomycin, 4 cryotherapy, 5 surgical excision, radiotherapy, laser therapy, or combination of techniques, and many others, but there is no satisfactory universal treatment that is effective in all keloids cases. 6 Verapamil is considered a calcium channel blocker that has emerged as a new therapeutic modality for keloids. 7 It alters the

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Trichloroacetic acid peeling is effective in the treatment of melasma, TCA 25% was the most effective concentration. Q-switched neodymium-doped:yttrium aluminum garnet laser is not recommended in the treatment of melasma because it was associated with the highest incidence of complications.

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