Subcutaneous intralesional Ksharodaka injection: A novel treatment for the management of Warts: A case series

Abstract

Warts are generally managed using cryosurgery, keratolytic ointments, curettage and electrodessication. Warts, vis-a-vis Charmakila, in Ayurvedic classical texts are classified into different types depending on the dominance of dosha. Ayurveda prescribes oral medications, topical use of Kshara (alkaline ash of herbs), Agni (thermal cautery) and Shastrakarma (surgery) for removal of Charmakila. Use of topical Kshara in the form of powder, aqueous solution i.e. Ksharodaka and Ksharasutra (thread smeared with Kshara) for warts has been reported. However, these methods necessitate multiple sittings and takea longer duration for removal of the warts. Herewith, we report a case series of different types of warts treated with intralesional infiltration of Apamarga Ksharodaka (AK), i.e. aqueous solution of Apamarga (Achyranthes aspera) Kshara. We observed that all these warts took a minimum of 2-6 days to shed off, leaving minor scars. There were no adverse reactions reported in any of these cases.

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

“…The host immune system is activated to recognize the virus, leading to wart clearance. [13][14][15][16][17][18] According to research conducted earlier Injecting PPD into the HPV-infected tissue generates strong proinflammatory signals and attracts antigen-presenting cells, which recognize HPV particles in the infected tissue leading to a strong adaptive immune response which helps in clearing the infection. The Th1 cytokines such as interleukin-4 (IL-4), IL-5, IL-8, interferons gamma, and tumor necrosis factor-alpha, which activates cytotoxic and natural killer cells that stimulate a strong immune response against HPV are mainly responsible for this process.…”

Intralesional Vitamin D Injection May Be an Effective Treatment Option for Warts

“…The treatment outcomes of different intralesional methods are summarized in Table 1. [7][8][9][10][11][12][18][19][20] In this study, 20 patients with plantar warts received intralesional vitamin D 3 treatment, and 16 patients (80%) achieved complete clearance after 2 injections. These results suggest that intralesional vitamin D 3 is more effective than intralesional PPD, bleomycin, and C albicans antigen treatment and is comparable to intralesional MMR and Mycobacterium w vaccine treatments.…”

“…While the mechanisms of vaccine and antigen therapy have not been elucidated, it is thought that the host immune system is activated to recognize the virus, leading to wart clearance. 7-12 This treatment approach is known as intralesional immunotherapy.…”

Efficacy and Safety of Intralesional Injection of Tuberculin PPD in Treatment of Plantar Warts

“…A new approach of intralesional (IL) immunotherapy has been developed for treatments of warts and included IL injections of tuberculin purified protein derivative (PPD); measles, mumps, and rubella (MMR) vaccine; Mycobacterium w(Mw) vaccine and Candida albicans antigen. While the mechanisms of vaccine and antigen therapy have not been fully understood, it is thought that the host immune system is activated to recognize the virus, leading to wart clearance [11][12][13] . The aim of this work was to evaluate the efficacy and safety of intralesional protein derivative (PPD) in the treatment of plantar warts.…”