Treatment of multiple warts: efficacy of homologous autoimplantation therapy and comparison of homologous autoimplantation therapy and cryotherapy with liquid nitrogen
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20193232Keywords:
Warts, Homologous Autoimplantation, CryotherapyAbstract
Background: Though a multitude of therapies are available, treating warts remains a challenge, more so if multiple. Cryotherapy, a commonly used treatment, has limitations. Homologous autoimplantation is a newer therapy for multiple warts. The aims of the study were to evaluate the efficacy of homologous autoimplantation therapy and compare it with cryotherapy with liquid nitrogen.
Methods: Hundred patients with multiple warts (≥5), were randomly selected and divided into two equal groups. One group was treated with cryotherapy with liquid nitrogen and the other with homologous autoimplantation. They were followed up for six months and the time taken for clearance of the lesions, complications and recurrences were compared.
Results: Homologous autoimplantation gave a higher cure rate (78%) than cryotherapy (56%). Complications like blistering, ulceration, scarring and post-inflammatory hyperpigmentation were higher with cryotherapy (40%) than autoimplantation (6%). The recurrence rate was 4% in the cryotherapy group and none in the other. But the time taken for the resolution was lower in the cryotherapy group (2.28 weeks) than the autoimplantation group (6.46 weeks).
Conclusions: Cryotherapy with liquid nitrogen and homologous autoimplantation are safe and effective therapies for warts but the latter carried a few advantages. The cure rate was higher, complications lower and recurrence was lower. Also autoimplantation can be of help in multiple warts where physical destruction of each and every wart is cumbersome. Hard to treat lesions like periungual warts, showed good results with autoimplantation.
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References
Drake LA, Ceilley RI, Cornelison RL, Dobes WL, Dorner W, Goltz RW, et al. Guidelines of care for warts: Human papilloma viruses. J Am Acad Dermatol. 1995;32:98-103.
Shivakumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatol Venereol Leprol. 2009;75:593-5.
Savant SS. Cryosurgery. In: Savant SS, editor. Textbook and atlas of dermatosurgery and cosmetology. 2nd ed. Mumbai: ASCAD; 2005: 117-135.
Kacar N, Tasli L, Korkmez S, Ergin S, Erdogan BS. Cantharidinpodophylotoxin- salicylic acid versus cryotherapy in the treatment of plantar warts: A randomized prospective study. J Eur Acad Dermatol Venereol. 2012;26(7):889-93.
Klug A, Flinch JT. Structure of viruses of the papilloma-polyoma type. 1. human wart virus. J Mol Biol. 1965;11:403-5..
Briggaman RA, Wheeler CE. Immunology of human warts. J Am Acad Dermatol. 1979;1:297-304.
Viac J, Thivolet J, Hegaz M, Chardonnet Y, Dambuyant C. Comparative study of delayed hypersensitivity skin reaction and antibodies to human papilloma virus (HPV). Clin Exp Immunol. 1977;29:240-6.
Morison W. In vitro assay of cell-mediated immunity to human wart antigen. Br J Dermatol. 1974;90:531-4.
Srivastava PK, Bajaj AK. Autowart injection therapy for recalcitrant warts. Indian J Dermatol. 2010;55:367-9.
Gupta S, Malhotra AK, Verma KK, Sharma VK. Intralesional immunotherapy with killed Mycobacterium w vaccine for the treatment of ano-genital warts: An open label pilot study. J Eur Acad Dermatol Venereol. 2008;22:1089-93.
Dhar SB, Rashid MM, Islam A, Bhuiyan M. Intralesional bleomycin in the treatment of cutaneous warts: A randomized clinical trial comparing it with cryotherapy. Indian J DermatolVenereol Leprol. 2009;75:262-7.
Cockayne S, Hewitt C, Hicks K, Jayakody S, Kang'ombe AR, Stamuli E, et al. Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): A randomized control trial. BMJ. 2011;342:d3271.
Focht DR 3rd, Spicer C, Fairchok MP. The efficacy of duct tape versus cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med. 2002;156(10):971-4.