Intralesional combined furosemide and digoxin in cutaneous warts treatment: A randomized controlled clinical trial

Abstract

Although being a benign lesion, Warts can affect the quality of life by causing discomfort, disfigurement, and social embarrassment besides the tendency to spread.Cutaneous wart treatment faces many challenges as the development of an antiviral drug that can eradicate the human papilloma virus (HPV) is difficult. This clinical study aimed to assess the efficacy and safety of intralesional combined furosemide and digoxin in the treatment of multiple cutaneous warts. This double blinded randomized clinical trial included 80 adult patients with multiple cutaneous warts (≥2 warts) who were randomized into two groups, Group I (40 patients) treated with intralesional combined furosemide and digoxin and Group II (40 patients) who were treated with intralesional normal saline solution as a control group, weekly till improvement or for maximum five sessions. Clinical and dermoscopic evaluation at baseline, every session, and monthly for 6 months after the last session to detect any recurrence was performed. Complete wart clearance was observed in 92.5% of patients in the intralesional combined furosemide and digoxin group (Group I) compared with 10.0% in saline group (Group II), with highly statistically significant difference (Pvalue = 0.000). Pain during injection in 95.0% and 45.0% of patients in Group I and Group II respectively, treatment group was superior compared to control group.Intralesional injection of combined furosemide and digoxin can be a safe and effective treatment option in multiple cutaneous warts with minimal side effects in this study.

Intralesional combined digoxin and furosemide versus intralesional 5-flurouracil for the treatment of recalcitrant plantar warts: a prospective, randomized study

“…This may be due to their scoring system, as they considered excellent response if there was 75–100% decrease in wart size as compared to a full disappearance (100%) in our study. Furthermore, it was much lower than other studies that reported more than 90% clearance [ 15 ]. This can be elucidated by the dissimilar concentration of the combined drugs.…”

A ProTide of AZT Shows Activity Against Human Papillomaviruses

“…Combinations of drugs have proven useful in the treatment of HPV-induced warts. [3] Independent of such speculations, there is hope that further optimized prodrugs of AZT for the treatment of infections with DNA viruses exist, and that our results will stimulate work leading to the identification of them.…”

“…Given the wealth of clinical data on AZT, it is reasonable to assume that adverse side effects are unlikely to become unsurmountable hurdles to the clinical use of this compound, perhaps in the form of combination therapy, as commonly practiced against HIV. Combinations of drugs have proven useful in the treatment of HPV‐induced warts [3] . Independent of such speculations, there is hope that further optimized prodrugs of AZT for the treatment of infections with DNA viruses exist, and that our results will stimulate work leading to the identification of them.…”

“…[2] Infections can occur by skin-to-skin contact and can be difficult to eradicate. [3] More than half a million cancer cases have been attributed to HPV, including cervical, anogenital and oropharyngeal cancer. [4] While vaccination against HPV has become a priority in many countries, treatment options for severe cases of neoplasms are limited, and no nucleosidic antiviral has been approved yet.…”

“…The virus is the causative agent for a number of human neoplasms, including warts, and cancers [2] . Infections can occur by skin‐to‐skin contact and can be difficult to eradicate [3] . More than half a million cancer cases have been attributed to HPV, including cervical, anogenital and oropharyngeal cancer [4] .…”