title: Intralesional immunotherapy compared to cryotherapy in the treatment of warts.
abstract: BACKGROUND
  Warts are the most common clinical manifestation of the human papilloma-virus infection in the skin and mucous membranes. In spite of the various therapeutic modalities for nongenital skin warts, there is still no single method to be used as an approved treatment. In this study, we compared the efficacy of immunotherapy and cryotherapy on wart lesions.
  
  
  METHODS
  Sixty patients with verruca vulgaris and plantar warts were randomly divided into two groups. One group received intralesional injection of candida antigen repeated every 3 weeks until complete improvement of all warts or for a maximum of three sessions. The second group was treated by cryotherapy with liquid nitrogen for a maximum of ten sessions or until clearance of all lesions. T-test and chi-square test were used for statistical analysis, and P < 0.05 was considered statistically significant.
  
  
  RESULTS
  The patients showed a significant therapeutic response to immunotherapy compared to cryotherapy (P = 0.023). Moreover, a significant difference was observed between the time-elapsed before treatment and the therapeutic response between both groups (P = 0.041). 76.7% of patients were completely cured with immunotherapy, while only 56.7% responded to cryotherapy. Complete remission was observed with fewer sessions (20.17 ± 0.65) in immunotherapy compared to cryotherapy (3.82 ± 2.481), but no statistically significant difference was shown between groups. Immunotherapy was well-tolerated except for the pain during injection that was the most common side effect.
  
  
  CONCLUSIONS
  Intralesional immunotherapy is an effective treatment of warts. This method has a better therapeutic response, needs fewer sessions, and is capable of treating distant warts.
authors.affiliation: Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fahime
authors.initials: F
authors.lastname: Khozeimeh
authors.affiliation: Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Farahzad
authors.initials: F
authors.lastname: Jabbari Azad
authors.affiliation: Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Yaghoub
authors.initials: Y
authors.lastname: Mahboubi Oskouei
authors.affiliation: Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Jafari
authors.affiliation: Clinical Research Development Unit, Quaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Tehranian
authors.affiliation: Department of Computer Engineering, Sharif University of Technology, Tehran, Iran.
authors.forename: Roohallah
authors.initials: R
authors.lastname: Alizadehsani
authors.affiliation: Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Pouran
authors.initials: P
authors.lastname: Layegh
mesh_terms: D000293:Adolescent; D000328:Adult; D000946:Antigens, Fungal / Q000627:therapeutic use*; D002176:Candida albicans / Q000276:immunology*; D017679:Cryotherapy; D005260:Female; D006801:Humans; D007167:Immunotherapy; D015552:Injections, Intralesional / Q000009:adverse effects; D008297:Male; D010146:Pain / Q000209:etiology; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014860:Warts / Q000628:therapy*; D055815:Young Adult
chemical_list: D000946:Antigens, Fungal