Bibisha BaaniyaKoshi Zonal Hospital, Nepal
Title: A comparative study to assess efficacy of intralesional MMR (measles, mumps, rubella) vaccine and intralesional Vitamin D3 in treatment of warts
Introduction and Objective: Intralesional immunotherapy is an upcoming method of wart treatment. They have been assessed in various studies with variable success rates. This study assesses and compares the efficacy of intralesional MMR vaccine and Vitamin D3 in treatment of warts.
Materials and Methods: Total of sixty-one patients were randomly divided into two groups. Thirty-one patients in Group A were treated with intralesional MMR vaccine, while thirty patients in group B received intralesional vitamin D3. In both groups, up to five warts were injected with 0.5ml of the drug in each session every three weeks. A maximum of five sessions were carried out. Side effects and response were recorded in each visit and follow-up was done for three months after the last dose.
Results: In group A, there was complete response in 80.6%, excellent response in 6.5%, good response in 9.7%, and no response in 3.2% of patients while in group B there was complete response in 73.4%, excellent response in 20.0%, good response in 3.3%, and no response in 3.3% of patients. Although response rate was slightly higher with MMR than Vitamin D, it was not statistically significant. Out of all patients who showed complete response, 4% in group A and 13.6% in group B had recurrence in follow–up. Pain was present in all patients but the duration was significantly higher in vitamin D3 group (p<0.001). Similarly, hyperpigmentation was also significantly higher in vitamin D3 group (p=0.006). Furthermore, swelling, ulceration, erythema, fatigue and hypervitaminosis D3 were present only in vitamin D3 group and fever was present only in MMR group.
Conclusions: Both intralesional MMR vaccine and vitamin D3 are effective, comfortable, and cost-effective modalities for the treatment of warts. However, frequency and duration of side effects and recurrence rate are higher with Vitamin D3 than MMR.
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