Comparison of the therapeutic effects of intralesional injection of vitamin D3 with cryotherapy with cryotherapy alone in the treatment of warts

Abstract

Wart is a worldwide prevalent infection caused by papillomaviruses (HPV). There are currently several treatments for warts, depending on the patient's condition, location, and the number of warts; But no specific and effective antiviral treatment has been identified for warts, and existing treatments often focus on destroying infected tissue. Indications for wart treatment including physical deformity, pain, dysfunction, wart-related psychological complications, risk of transmission, and risk of malignancy. Cryotherapy is often used as the first-line treatment for wart. In this method, wart-infected tissue is destroyed by cold, but it is often associated with complications such as pain, blisters, scars, and infection. Also, patients must have frequent visits to achieve the desired result. On the other hand, vitamin D inhibits cell proliferation, induces apoptosis, induces cell differentiation, regulates the production of cytokines and induces antibacterial peptides in the skin, and can be an immunotherapeutic agent when injected directly into lesions. Due to the prevalence of this disease in the community and the lack of an efficient and cost-effective therapeutic method, and reduce the number of patient medical visits, and on the other hand, the adopted treatment method has no significant side effects and does not lead to scarring at the treatment site, we decided to investigate a treatment that seems effective, low cost and low complication in the treatment of wart to use this method to treat other patients with warts, in case of acceptable therapeutic effects. Patients and Methods: The study was completed from April 2020 to October 2020 at Dermatology Department of Sina Hospital. In this clinical trial study, 40 out of patients referred to the dermatology clinic of Sina Hospital, Tabriz University of Medical Sciences, were included in the study and divided into two groups. In group A, 20 patients receive an intralesional injection of vitamin D3 with cryotherapy, and in group B, 20 patients receive cryotherapy alone. Each time patients are examined for the response to treatment and complications. Finally, the two groups were analyzed in terms of response to treatment and complications. Results: Overall, after completing the treatment process sessions, the recovery rate of lesions in the group that also received vitamin D was 95.33 ± 5.87, while in the cryotherapy group alone it was 71.33 ± 27.27, which shows a significant difference (P <0.01). 57% (26 out of 45) of the lesions in the intervention group were completely cured after 4 sessions and the rest showed a moderate response to this treatment. Except for pain during injection, this treatment did not cause any significant side effects for the patients.