Safety and effectiveness of autoinoculation therapy in cutaneous warts: a double--blind, randomized, placebo--controlled study.
BACKGROUND
In spite of the availability of multiple treatment options, viral warts are known for their persistence and recurrence, causing frustration to patients and treating physicians.


OBJECTIVE
To study the effectiveness and safety of autoinoculation as a treatment modality in cutaneous warts.


METHODS
A double-blind, placebo-controlled study was carried out. In the treatment group, full-thickness warty tissue was excised, minced and implanted in a small dermal pocket. In the control group, warty tissue was only excised and not implanted, though a dermal pocket was made. Patients were evaluated every four weeks with lesion counts. The procedure was repeated at 4 and 8 weeks. Response was assessed at each visit and at 12 weeks.


RESULTS
Forty-eight patients with cutaneous warts (male: female=32:16) were randomized into autoinoculation and control groups. The number of warts at baseline was comparable in both groups (P=0.293). Reduction in the number of warts was significantly more in the autoinoculation group (8.50±13.88) than in the control group (10.04±5.80) from 8 weeks onwards (P=0.010). Complete resolution occurred only in the autoinoculation group, in 62.5% of cases. Adverse effects were seen in 11 patients, including infection of the donor site (5 cases), keloid formation (3) and hypopigmentation (3).


CONCLUSIONS
Autoinoculation may be an effective therapeutic modality for cutaneous warts and two sessions may be required for optimum results.
Niharika Ranjan
NR
Lal
Amrita
A
Sil
Tirthankar
T
Gayen
Debabrata
D
Bandyopadhyay
Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
Nilay Kanti
NK
Das
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016233:Immunotherapy, Active / Q000009:adverse effects / Q000379:methods*; D007279:Injections, Subcutaneous; D008297:Male; D012871:Skin Diseases / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome; D014860:Warts / Q000276:immunology* / Q000628:therapy*; D055815:Young Adult