Comparative Study in Efficacy and Safety of Intralesional Injections of Vitamin D3, Measles Rubella (MR) Vaccine, and Purified Protein Derivative (PPD) in the Management of Cutaneous Warts

INTRODUCTION: Cutaneous warts caused by human papillomavirus are the most common dermatological diseases being contagious, recurrent, and recalcitrant. Most routinely used treatment modalities are destructive and can cause scarring. Immunotherapy is emerging as new modality of treatment, which enhances cell-mediated immunity against human papillomavirus for clearance of both treated and distant warts. AIMS: The aim of this study was to compare efficacy between intralesional Vitamin D3, measles rubella (MR) vaccine, and purified protein derivative (PPD) injection in cutaneous warts. SETTINGS AND DESIGN: This was a hospital-based interventional study. MATERIALS AND METHODS: A total of 50 patients diagnosed with cutaneous warts were selected and divided into three groups with 15 patients in each. Treated with Vitamin D3 2 units of 6,00,000IU (15 mg/mL), 0.5 mL/dose 2 units of MR vaccine, and 10 TU of tuberculin PPD (0.1 mL) with 2 units of injections, respectively, with minimum three injections at 2-week intervals given. Follow-up of patients were done for 4 months. STATISTICAL ANALYSIS USED: A total of 45 patients were enrolled in the study and divided into three groups containing 15 patients each with the help of computer-generated random numbers. RESULTS: Patients treated with Vitamin D3 showed complete clearance (12/15) with 3–4 sessions; side effect was pain at the site of injection. Injection with PPD was effective with complete clearance (10/15) but the number of session was higher. MR vaccine needs 6–8 sessions for complete clearance (3/15). Palmoplantar warts were more responding to treatment. CONCLUSION: Intralesional Vitamin D3, MR vaccine, and PPD are equally efficient in treating verrucae, although Vitamin D3 can be considered safe.