title: Efficacy of intralesional immunotherapy for the treatment of warts: A review of the literature.
abstract: Warts are common epidermal growths caused by human papillomavirus that often cause significant discomfort and embarrassment. Current treatment options include topical therapies, cryotherapy, laser vaporization, and surgical excision. Many of these options are destructive and may result in scarring, while less aggressive approaches can lead to lesion recurrence. Additionally, these local modalities are not practical for patients with a large number of warts. Systemic approaches such as immunotherapy have demonstrated success in treating multiple lesions by combining a targeted approach with upregulation of the host immune system. An extensive literature review was performed to evaluate the various vaccine antigens that have been used intralesionally to treat cutaneous and anogenital warts. The specific intralesional immunotherapies that have been studied include: Candida albicans; measles, mumps, and rubella; Trichophyton; and tuberculin antigens such as purified protein derivative, Mycobacterium w vaccine, and Bacillus Calmette-Guerin. Intralesional vaccine injection represents a safe, effective, and tolerable treatment for warts, including recalcitrant and anogenital warts. This approach has been somewhat overlooked in the past despite substantial evidence of high response rates with a low side effect profile. Large comparative trials are necessary to determine the most effective immunotherapy treatment option as well as the most appropriate dosing parameters.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Adam Souhail
authors.initials: AS
authors.lastname: Aldahan
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mlacker
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Vidhi V
authors.initials: VV
authors.lastname: Shah
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Preetha
authors.initials: P
authors.lastname: Kamath
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alsaidan
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Sahal
authors.initials: S
authors.lastname: Samarkandy
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Nouri
mesh_terms: D000941:Antigens / Q000008:administration & dosage* / Q000009:adverse effects; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D015552:Injections, Intralesional; D016896:Treatment Outcome; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D014860:Warts / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*
chemical_list: D000941:Antigens; D014612:Vaccines
keywords: immunotherapy; intralesional; vaccines; verruca; warts