DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20204436

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

Sukanya G., Ashok Kumar N., Manoharan D., Manoharan K.

Abstract


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.


Keywords


Intralesional, Tuberculin PPD, Cell mediated immunity, Human papilloma virus

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References


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