Immunotherapy of viral warts: myth and reality

El‐Khalawany, Mohamed; Shaaban, Dalia; Aboeldahab, Soha

doi:10.4103/1110-6530.162451

Cited by 23 publications

(29 citation statements)

References 2 publications

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“…21 The mechanism of action of this type of immunotherapy depends on the activation of CD4 lymphocytes and an increase in cytokines such as interleukinIL-1, IL-2, and TNF-αwhich have been shown to have antiviral effects on HPV through the down regulation of its gene transcription. 23 In the BCG group, local side effects like painful nodules and blisters developed at the site of injection in 61.5 % and 7.7% of the cases respectively. The patients were given oral analgesics till the pain subsided, which was usually within one week.…”

Section: Discussionmentioning

confidence: 93%

Role of physiotherapy in palliative care

Rajashekar¹,

Amulya²,

Sathish³

et al. 2020

IJN

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Introduction: Multiple cutaneous warts are often asymptomatic, cosmetically disfiguring and difficult to treat with conventional modalities, hence immunotherapeutic modalities can be used in such cases. There are no comparitive studies with immunotherapeutic modalities for the treatment of multiple and extensive warts. This study aims to compare the efficacy and safety of intralesional BCG and PPD in the treatment of multiple cutaneous warts. Materials and Methods: It is a double blinded randomized clinical trial involving thirty patients having more than ten cutaneous warts with a positive mantoux reaction. The patients were randomly allocated into two treatment groups, group A -PPD and group B -BCG. Intralesional injections were given at two weekly intervals till complete clearance of all the warts or for a maximum of four sessions in both the groups. Response in injected warts and distant warts was assessed at each visit and sequential clinical photographic records were maintained. Results: Thirty patients with positive mantoux reaction were enrolled for the trial, 17 patients in group A (PPD) and 13 patients in group B (BCG). Complete resolution of lesions was noted in 35.3% in PPD group and 30.8% in BCG group and partial resolution was noted in 47.0% and 38.4 % in PPD and BCG group respectively. Conclusion: Intralesional PPD showed marginally better results than intralesional BCG in the treatment of multiple cutaneous warts. Majority of the patients treated with BCG had tender nodule at injection site.

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Section: Discussionmentioning

confidence: 93%

Role of physiotherapy in palliative care

Rajashekar¹,

Amulya²,

Sathish³

et al. 2020

IJN

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“…Immunotherapy has become one of the important therapeutic tool. 8 Intralesional immunotherapy has been shown to be associated with release of different cytokines. Several immunotherapeutic agents with variable efficacy have been used for the treatment of warts.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic evaluation of intralesional measles, mumps and rubella vaccine in palmoplantar warts

Geetha

2019

Int J Res Dermatol

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Background: Warts are common viral infections of the skin caused by human papilloma virus. Most of the treatment modalities for common warts remain unsatisfactory. Immunotherapy has become one of the important therapeutic modality. This study was conducted to evaluate the efficacy of intralesional measles, mumps and rubella (MMR) vaccine immunotherapy in palmoplantar warts.Methods: 60 patients of various age groups and both sexes who have single or multiple palmoplantar warts not on any other concurrent systemic or topical therapy were randomly included for the study. Patients with other types of warts, signs of other infection, pregnancy, lactation and immunosuppression were excluded from the study. MMR Vaccine was injected intralesionally at 2 week intervals until complete clearance or for a maximum of 3 treatments. The outcome in terms of treatment relapse, recurrences and adverse effects were evaluated.Results: Only 54 patients completed the study and 41 (75.9%) of them showed complete response and 13 (24%) of them showed partial or no response.Conclusions: Intralesional MMR vaccine therapy appears to be a safe and effective treatment option with no significant adverse effects and low recurrence.

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“…Other intralesional therapies include bleomycin, interferon, Candida albicans antigen, measles-mumps-rubella (MMR) vaccine, lipid garlic extract (LGE), bacillus calmette guérin (BCG) vaccine and mycobacteriumindicuspranii vaccine. 2,3 A nonspecific immunological response is activated by the Th1 cytokines which further stimulate the natural killer cells and cytotoxic T cells leading to a delayed form of hypersensitivity response that augments host immune status. This is the basis for lesion clearance at not only the injection site but also at distant sites.…”

Section: Introductionmentioning

confidence: 99%

Intralesional immunotherapy with purified protein derivative antigen in the treatment of multiple cutaneous warts: an open label study in an urban teaching hospital

et al. 2020

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Background: Viral warts caused by human papilloma virus are a group of oncogenic viruses that result in verrucous growths on the skin and mucosae. Intralesional immunotherapy has been tried in recent years with success with the use of a variety of antigens to non-specifically stimulate the cell mediated immune response. Similarly, we undertook a study to evaluate the efficacy and safety of tuberculin purified protein derivative as an immunotherapeutic modality.Methods: A total of 25 patients were included in the study. Each patient was injected with 2.5 TU of tuberculin PPD (0.04 ml) intralesionally into most of the warts at 2 weekly intervals for a maximum of six sessions. It is an interventional study with follow-up upto 6 months. Descriptive analysis was done with use of SPSS version 23 tool. Complete resolution of warts was considered as the clinical end point. Response was graded as excellent response (>80% resolution), good response (50-80%), fair response (20-50%) and no response (<20%).Results: Out of the 25 patients, 14 patients showed excellent response (56%), 4 patients showed good response (16%), 5 patients showed fair response (20%) and 2 patients did not show any response (8%). Over 22 patients (88%) showed features of pain, erythema and inflammation at the injection site, whereas 3 patients (12%) developed itching at the site. The ‘faces’ pain rating scale was used to measure pain tolerance. An overall response rate (fair/good/ excellent) was given by 23 out of the 25 patients (92%), which proved satisfactory.Conclusions: Intralesional immunotherapy with PPD effectively cures warts which are present locally and also at distant sites. It is safe, economic and efficacious.

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Immunotherapy of viral warts: myth and reality

Cited by 23 publications

References 2 publications

Role of physiotherapy in palliative care

Role of physiotherapy in palliative care

Therapeutic evaluation of intralesional measles, mumps and rubella vaccine in palmoplantar warts

Intralesional immunotherapy with purified protein derivative antigen in the treatment of multiple cutaneous warts: an open label study in an urban teaching hospital

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