Factors contributing to the treatment duration of diphenylcyclopropenone immunotherapy for periungual warts

Abstract

Diphenylcyclopropenone (DPCP) immunotherapy has been shown to be efficacious for the treatment of warts, especially periungual warts for which destructive techniques are limited. However, factors affecting the duration of treatment of periungual warts have not been studied. A total of 61 patients with periungual warts who were completely cured with DPCP immunotherapy were included in this study. Age, sex, disease duration, location (fingernail, toenail, or both), number of warts, diameter of the largest wart, application number for sensitization and two types of sensitization reactions, erythema and blister index (EBI), and pruritus index were evaluated. Multiple linear regression analysis was performed to find correlations of these variables with the treatment duration. Of the nine variables, application number for sensitization (regression coefficient = 3.251 and 2.428, respectively) and EBI (regression coefficient = -9.950 and -9.694, respectively) were independent factors significantly affecting both the total duration of treatment and the duration of treatment after sensitization (p < 0.05, respectively). The sample size was limited. A shorter sensitization period and more severe EBI of the sensitization reaction contribute to a shorter time required for a complete cure in the treatment of periungual warts with DPCP immunotherapy.

What factors affect the duration of treatment with diphenylcyclopropenone immunotherapy for common warts?

“…a Other areas including dorsum of hand, arm, or leg. (Park & Kim, 2016). The reason for this is unclear, but we thought that the small sample size in the previous study precluded achievement of statistical significance.…”

“…(Kilkenny, Merlin, Young, & Marks, 1998;Kyriakis et al, 2007;van Haalen, Bruggink, Gussekloo, Assendelft, & Eekhof, 2009) In our recent study of 61 patients with periungual warts, we found that the number of sessions for sensitization and the erythema and blister index (EBI) were independent factors significantly affecting not only the total duration of treatment, but also the treatment duration after sensitization. (Park & Kim, 2016) However, the small number of subjects and the limited location (i.e., periungual region) of the warts may limit the generalizability of the study. The aim of the present study was to evaluate factors affecting treatment duration in subjects with common warts.…”

“…Subjects with warts in anogenital location were excluded. The 61 patients with periungual warts in our previous study were also included (Park & Kim, 2016). The present study was conducted according to the principles of the Declaration of Helsinki.…”

“…If there was no response to two consecutive sessions, the concentration of DPCP was increased. Treatment details have been described elsewhere (Park & Kim, 2016). The responses to DPCP were evaluated using the EBI and the pruritus index (PI) (Kang, Lee, Paek, Yu, & Kim, 2014).…”

“…The reason for this is unclear, but we thought that the small sample size in the previous study precluded achievement of statistical significance. With regard to sensitization reaction, it has been hypothesized that the severity of the local reaction for sensitization is associated with potent cell-mediated immunity (Park & Kim, 2016). As a result, patients with severe local reactions would have had good therapeutic responses.…”