Effect of intralesional measles mumps rubella immunotherapy in cutaneous viral warts
Keywords:Measles mumps rubella, Human papilloma virus, Immunotherapy, Verruca vulgaris
Background: Viral warts are benign proliferation of the skin and mucosa caused by various strains of double stranded DNA human papilloma virus (HPV). MMR immunotherapy of warts is a novel, simple, cost-effective procedure which treats wart by stimulation of non-specific cell mediated immune response to clear HPV virus from the skin. A study to evaluate the role of intralesional measles mumps rubella (MMR) immunotherapy in cutaneous viral warts.
Methods: Total 22 patients of both sexes were included in the study. Intralesional MMR 1 unit (0.1 ml) was injected into the largest wart at 2 weeks interval for a maximum of six treatments. Maximum dose of immunotherapy was 0.5 ml for one session and follow up was kept for 3 months duration.
Results: Out of 22, 20 patients completed the treatment, 12 patients (60%) shows complete response, 5 patients (25%) shows partial response and 3 patients (15%) shows no response.
Conclusions: Intralesional measles mumps rubella (MMR) immunotherapy is an easy, simple, minimally invasive and relatively painless technique, which helps in induction of an adequate immune response leading to resolution of warts.
Bolognia JL, Jorizzo JL, Julie V, Schaffer MD. Textbook of Dermatology: 3rd Edition, 2008 Mosby-elsevier publication, section 12, C78, 2008.
Pancos N, Velarde HH, Seinwill MR. Surgical autoimmunization against verruca plantaris via autogenic graft of papilloma in situ. Current Podiatry. 1980;23:23.
Shivakumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatol Venereol Leprol. 2009;75(6):593-5.
Roden RB, Lowy DR, Schiller JT. Papillomavirus is resistant to desiccation. J Infect Dis. 1997;176:1076-9.
Srivastava PK, Bajaj AK. Autowart injection therapy for recalcitrant warts. Indian J Dermatology. 2010;55(4):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.
Nofal A, Nofal E. Intralesional immunotherapy of common warts: Successful treatment with mumps, measles and rubella vaccine. J Eur Acad Dermatol Venereol. 2010;24:1166-70.
Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D. Textbook of Rooks of Dermatology: 9th edition. Wiley-Blackwell publication. 2010: 33.37-33.55.
Dhope A, Madke B, Singh AL. Effect of measles mumps rubella vaccine in treatment of common warts. Indian J Drugs Dermatol (serial online). 2017;3:14-9.
Zamanian A, Mobasher P, Jazi GA. Efficacy of intralesional injection of mumps-measles-rubella vaccine in patients with wart. Adv Biomed Res. 2014;3:107.
Meena JK, Malhotra AK, Mathur DK, Mathur DC. Intralesional immunotherapy with Mycobacterium w vaccine in patients with multiple cutaneous warts: Uncontrolled open study. JAMA Dermatol. 2013;149:237-9.
Mohamad NS, Badran F, Yakout E. Evaluation of the efficacy of a combination: Measles, mumps and rubella vaccine in the treatment of plantar warts. Our Dermatol Online. 2013;4:463-7.
Nimbalkar A, Pande S, Sharma R, Borkar M. Tuberculin purified protein derivative immunotherapy in the treatment of viral warts. Indian J Drugs Dermatol. 2016;2:19-23.
Nofal A, Nofal E. Intralesional immunotherapy of common warts: successful treatment with mumps, measles and rubella vaccine. J Eur Acad Dermatol Venereol. 2010;24:1166-70.
Gamil H, Elgharib I, Nofal A, Elaziz AT. Intralesional immunotherapy of plantar warts: report of a new antigen combination. J Am Acad Dermatol. 2010;63:40-3.
Brunk D. Injection of Candida antigen works on warts. Skin Allergy News. 1999;30:5.
Gupta S, Malhotra AK, 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.
Johnson SM, Roberson PK, Horn TD. Intralesional injection of mumps or candida skin test antigens: A novel immunotherapy for warts. Arch Dermatol. 2001;137:451-5.