Role of intralesional vitamin D3 in cutaneous warts: an interventional study


  • Sweta S. Kumar Department of Dermatology, UPUMS, Saifai, Etawah, U.P, India
  • Sankalp Awasthi Department of Dermatology, UPUMS, Saifai, Etawah, U.P, India
  • Adesh Kumar Department of Dermatology, UPUMS, Saifai, Etawah, U.P, India
  • Prateek Jain Department of Dermatology, UPUMS, Saifai, Etawah, U.P, India



Multiple warts, Vitamin D3, Immunomodulation, Immunotherapy


Background: Cutaneous warts are treated primarily with destructive methods such as cryotherapy or electrocautery. These modalities of treatment may be associated with recurrence and scarring in multiple warts. This study aims to evaluate the efficacy and safety of intralesional vitamin D3 in warts.

Methods: 88 patients with recalcitrant warts of varying sizes and duration were included in the study. About 0.2 to 0.5 ml vitamin D3 solution (600,000 IU, 15 mg/ml) was injected to the base of the wart. A maximum of 5 warts were injected per session at 3-week intervals until resolution or for a maximum of 4 treatments. Patients were followed up for 6 months after the last injection to detect any recurrence.

Results: 88 patients completed the study. Complete response was seen in 63 out of 88 (71.5%), partial response in 24 out of 88 (27.2%), and no response seen in one patient. The average number of injections required to achieve a complete resolution was 3.66. Complete resolution of distant warts was noticed in all the patients.

Conclusions: Intralesional vitamin D3 is a safe, effective, and an inexpensive treatment option for recalcitrant warts.


Author Biography

Sweta S. Kumar, Department of Dermatology, UPUMS, Saifai, Etawah, U.P, India

Assisitant professor, department of dermatology


Gibbs S, Harvey I, Sterling J, Stark R. Local treatments for cutaneous warts: Systematic review. BMJ. 2002;325:461.

Savant SS, Shah RA, Gore D. Electrosurgery. Textbook and Atlas of Dermatosurgery and Cosmetology. Mumbai: ASCAD; 2005: 305‑314.

Bourke JF, Jones BJ, Hutchinson PE. Cryotherapy of common viral warts at intervals of 1, 2 and 3 weeks. Br J Dermatol. 1995;132:433‑6.

Tan OT, Hurwitz RM, Stafford TJ. Pulsed dye laser treatment of recalcitrant verrucae: A preliminary report. Lasers Surg Med. 1993;13:127.

Goncalves MA, Donadi EA, Immune cellular response to HPV: Current concepts, Braz J Infect Dis. 2004;8:1-9.

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.

Shaheen MA, Salem SA, Fouad DA, El‑Fatah AA. Intralesional tuberculin (PPD) versus measles, mumps, rubella (MMR) vaccine intreatment of multiple warts: A comparative clinical and immunological study. Dermatol Ther. 2015;28:194‑200.

Garg S, Baveja S. Intralesional immunotherapy for difficult to treat warts with Mycobacterium w vaccine. J Cutan Aesthet Surg. 2014;7:203‑8.

Majid I, Imran S. Immunotherapy with intralesional Candida albicans antigen in resistant or recurrent warts: A study. Indian J Dermatol. 2013;58:36-45.

Moscarelli L, Annunziata F, Mjeshtri A. Successful treatment of refractory wart with a topical activated vitamin D in a renal transplant recipient. Case Rep Transplant. 2011;2011:368623.

Rind T, Oiso N, Kawada A. Successful treatment of anogenital wart with a topical vitamin D3 derivative in an infant. Case Rep Dermatol. 2010;2:46-9.

Ghamdi AK, Kumar A, Moussa N. The role of vitamin D in melanogenesis with an emphasis on vitiligo. Indian J Dermatol Venereol Leprol. 2013;79:750-8.

Imagawa I, Suzuki H. Successful treatment of refractory warts with topical vitamin D3 derivative (maxacalcitol, 1alpha, 25-dihydroxy-22-oxacalcitriol) in 17 patients. J Dermatol. 2007;34:264-6.

Aktas H, Ergin C, Demir B, Ekiz O. Intralesional vitamin D injection may be an effective treatment option for warts. J Cutan Med Surg. 2016;20:118‑22.

Saoji V, Lade NR, Gadegone R, Bhat A. Immunotherapy using purified protein derivative in the treatment of warts: An open uncontrolled trial. Indian J Dermatol Venereol Leprol. 2016;82:42‑6.

Lee JY, Kim CW, Kim SS. Preliminary study of intralesional bleomycin injection for the treatment of genital warts. Ann Dermatol. 2015;27:239‑41.

Nofal A, Nofal E, Yosef A, Nofal H. Treatment of recalcitrant warts with intralesional measles, mumps, and rubella vaccine: A promising approach. Int J Dermatol. 2015;54:667‑71.

Singh S, Chouhan K, Gupta S. Intralesional immunotherapy with killed Mycobacterium indicus pranii vaccine for the treatment of extensive cutaneous warts. Indian J Dermatol Venereol Leprol. 2014;80:509‑14.

Sterling JC, Jones HS, Hudson PM. British Association of Dermatologists. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001;144:4‑11.

Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR et al. Toll‑like receptor triggering of a Vitamin D‑mediated human antimicrobial response. Science. 2006;311:1770‑3.

Kavya M, Madegowda B, Shweta BP, Intralesional vitamin D3 injection for the treatment of difficult warts. J Cutan Aesthet Surg. 2016;7:203‑8.

Raghukumar S, Ravikumar BC, Vinay KN, Suresh MR, Aggarwal A, Yashovardhan DP. Intralesional Vitamin D3 injection in treatment of recalcitrant warts: a novel proposition. J Cutan Med Surg. 2017;21(4):320-4.






Original Research Articles