A Randomised Single-Blind Controlled Trial Comparing Efficacy of Intralesional Vitamin D Injection and MMR (Measles, Mumps, Rubella) Vaccine in Treatment of Warts.

Abstract

Introduction: Common warts are benign skin lesions caused by human papillomavirus (HPV) infection. They are often resistant to conventional treatments and may cause cosmetic and psychological distress. Immunotherapy is a promising alternative that stimulates the host immune system to clear the virus and the infected cells. This study compared the efficacy and safety of two immunotherapeutic agents, intralesional measles, mumps, and rubella (MMR) vaccine and intralesional vitamin D, in the treatment of common warts.

Methods: This was a single-blind randomised controlled trial conducted at a tertiary care hospital in Kolkata, India. Patients aged 12 years or older with common warts were randomly assigned to receive either intralesional MMR vaccine or intralesional vitamin D every 3 weeks for a maximum of three doses or until complete resolution, whichever was earlier. The primary outcome was the reduction in the size of the largest wart. Secondary outcomes included patients' and physicians' global assessment, complete response rate, adverse effects, and recurrence rate.

Results: A total of 36 patients were enrolled and analysed. Both MMR and vitamin D groups showed a significant reduction in the size of the largest wart throughout the treatment period (P < 0.0001). There was no significant difference between the two groups in terms of size reduction, patients' and physicians' global assessment and adverse effects. The complete response rate was higher in the MMR group (64.7%) than in the vitamin D group (36.8%); however, the difference was not statistically significant (P = 0.14). The recurrence rate was low in both groups (5.9% in the MMR group and 10.5% in the vitamin D group).

Conclusion: Both intralesional MMR vaccine and intralesional vitamin D are effective and safe immunotherapeutic options for the treatment of common warts. MMR vaccine may have a slight advantage over vitamin D in terms of complete response rate; however, further studies with larger sample sizes and longer follow-ups are needed to confirm this finding.