A Comparative Analysis of Efficacy of Intralesional Mumps-Measles-Rubella Vaccine Versus 5-Fluorouracil in the Treatment of Palmoplantar Warts

BACKGROUND: Palmoplantar warts are quite resistant to treatment, so treating them is a challenge as ablative modalities lead to pain, temporary immobility, secondary infections, and scarring. The treatment of warts using immunotherapeutic methods and cytotoxic methods is being increasingly used to overcome drawbacks in the treatment of warts. AIM: To evaluate the efficacy and safety of intralesional mumps-measles-rubella (MMR) vaccine versus 5-fluorouracil (5-FU) in the treatment of palmoplantar warts. MATERIALS AND METHODS: A total of 36 patients were divided into two groups of 18 each, MMR and 5-FU groups, respectively. The patients in the MMR group were given 0.1ml - 0.5ml of intralesional MMR vaccine in each lesion depending on the dimensions of the lesion and was repeated at 2 weekly intervals until complete clearance or a maximum of six doses. The patients in the 5-FU group were given 0.1ml - 0.5ml of intralesional injection of a solution containing 4 mL of 250 mg/mL of 5-FU and 1 mL of a mixture of 20 mg/mL (2%) lidocaine and 0.0125 mg/mL of epinephrine, which was given at 2 weekly intervals until complete clearance or maximum six doses. RESULTS: In our study, warts had resolved in all 18 (100%) patients belonging to the MMR group by the 12(th) week, whereas 11 (61.11%) patients still had warts among the patients belonging to the 5-FU group (i.e., warts had resolved only in 7 (38.89%) patients at the end of 12(th) week), which was found to be statistically significant (P-value < 0.05). LIMITATION: Smaller sample size and lack of follow-up to evaluate for possible recurrence. CONCLUSION: MMR vaccine is a safe and effective treatment modality for palmoplantar warts compared to 5-FU.