Efficacy of intralesional MMR vaccine for the management of cutaneous warts in adults

Abstract

Background: No single treatment for warts has proven 100% efficacy and most therapeutic modalities remain unsatisfactory. Immunotherapy with Measles-Mumps-Rubella (MMR) vaccine remains a key treatment of interest. The study done from August 2020 to March 2021 in the department of Dermatology, KIMS hospital, Narketpally. Telangana state. Objective: To evaluate the efficacy of intralesional MMR vaccine in the treatment of cutaneous warts in adults. Patients and Methods: Fifty patients (34 men and 16 women) aged 18-61 (mean ± standard deviation = 34.58 ± 11.74) years with common warts received 0.25 ml of MMR vaccine injected intralesionally in the largest wart. The dose was repeated at 2-week interval until complete clearance or for a maximum of 5 doses. Thereafter, they were followed up once a month for 24-week study period. The response was evaluated as complete clearance (complete disappearance of the wart(s) including distant ones and appearance of normal skin), partial clearance (≤99% reduction in size and number including distant ones and few residual warts still visible), good response (some reduction in size only including that of distant ones but no decrease in number of warts), or poor response (no change in size and number). Results: 50 patients completed the study and 29 (58%) of them had complete clearance of warts, 14 (28%) showed partial clearance and 5 (10%) patients showed good response. Complete clearance of warts occurred after five doses in 19 (38%) patients and after 4 doses in 9 (18%) patients. Conclusion: MMR vaccine is a promising treatment modality for common warts, particularly the multiple and recalcitrant ones. It seems to be inexpensive, effective and safe option that has the potential advantages of widespread and sustained effects against HPV. Intralesional MMR also appears to be much less painful and safe than traditional destructive methods for wart treatment, and thus seems to be better tolerated.