title: Immunotherapy in viral warts with intradermalBacillusCalmette-Guerin vaccine versus intradermal tuberculin purified protein derivative: A double-blind, randomized controlled trial comparing effectiveness and safety in a tertiary care center in Eastern India.
abstract: BACKGROUND
  Current therapeutic modalities for viral warts are mostly ablative and are limited by high recurrence rates besides being unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations.
  
  
  OBJECTIVE
  The aim of this study was to compare the effectiveness and safety of Bacillus Calmette-Guerin vaccine versus tuberculin purified protein derivative in the immunotherapy of warts.
  
  
  METHODS
  Patients received three doses of 0.1 ml of Bacillus Calmette-Guerin vaccine or tuberculin purified protein derivative intradermally over the deltoid region at 4-weekly intervals. They were followed-up for another month. Number of warts, complete cure rates and quality of life were assessed.
  
  
  RESULTS
  A total of 60 patients were included. Complete clearance was noted in 16 (48.5%) out of 33 patients in the Bacillus Calmette-Guerin group and in 5 (18.5%) out of 27 in the tuberculin purified protein derivative group (P = 0.121). The number of lesions reduced statistically significantly from baseline in both the groups (P < 0.001) from the first follow-up visit onward (P < 0.05). The reduction was statistically significantly more in the Bacillus Calmette-Guerin group than in the tuberculin purified protein derivative group from the second follow-up onward. Dermatologic life quality index improved statistically significantly with both treatments. Adverse events (pain during injection, abscess formation and scarring at injection site) were more frequent with Bacillus Calmette-Guerin. No recurrence was seen after lesions cleared.
  
  
  CONCLUSIONS
  Patients were not followed up for more than 4 weeks after treatment. We could not estimate the cytokine levels or the peripheral blood mononuclear cell proliferation in response to Bacillus Calmette-Guerin/tuberculin purified protein derivative injections.
  
  
  CONCLUSIONS
  Both intradermal Bacillus Calmette-Guerin and tuberculin purified protein derivative hold promise in the treatment of viral warts. Bacillus Calmette-Guerin may be more effective, though it had more adverse events in our study.
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Indrashis
authors.initials: I
authors.lastname: Podder
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Sabari
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Mishra
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Tushar Kanti
authors.initials: TK
authors.lastname: Sarkar
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Somodyuti
authors.initials: S
authors.lastname: Chandra
authors.affiliation: Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Amrita
authors.initials: A
authors.lastname: Sil
authors.affiliation: Department of Biochemistry, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Santasmita
authors.initials: S
authors.lastname: Pal
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Abanti
authors.initials: A
authors.lastname: Saha
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Koushik
authors.initials: K
authors.lastname: Shome
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Nilay Kanti
authors.initials: NK
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D001500:BCG Vaccine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007194:India / Q000453:epidemiology; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014373:Tuberculin / Q000008:administration & dosage*; D014860:Warts / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001500:BCG Vaccine; D014373:Tuberculin