JUNE 30, 2005

Wart me worry?

Immunotherapy rids patients of multiple
warts with a single-site injection

Julie H, an avid runner, was determined to run a marathon before her 40th birthday. But three months before the big race, what began as a minor irritation on the ball of her right foot soon developed into three painful plantar warts that disrupted her training. She faced painful laser or liquid nitrogen treatment that would dash her dream. Fortunately, an alternative may soon be available for folks like Julie.

Dermatologist Dr Thomas Horn and colleagues at the University of Arkansas for Medical Sciences have developed a technique that could eradicate multiple warts by simply treating a single site. The novel approach involves injecting warts with antigens similar to those used to test for allergic reactions. Interestingly, even though the antigens used were against common pathogens that cause other human diseases, the body seemed to mount a response to HPV.

"This should become . . . a routine treatment in our box of tools for patients with warts, whether that's a patient with a single wart or patients with multiple warts. It is effective, safe and relatively painless," said Dr Horn in a statement to the Canadian Press.

In a study led by Dr Horn and published in the May issue of the Archives of Dermatology, half of the 233 participants were injected with antigens for mumps, Candida or Trichophyton (athlete's foot fungus). Of these, 60% emerged wart-free, regardless of which antigen was used. Only one wart was injected for each subject yet, for half of the patients, immunotherapy eliminated all their other warts, even genital warts. Immunotherapy has a success rate that's comparable with the reported rate for salicylic acid treatment (75%). The jury is still out on cryotherapy — some reports show a better than placebo response and others not.

"While useful in any patient with warts, intralesional immunotherapy may be particularly useful in patients with numerous lesions or lesions covering large surface areas," say the authors. Multiple treatments, every three weeks, may be needed to do the trick.

Arch Dermatol May 2005;141:589-94



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