Topical Vitamin D3 Derivative (Calcipotriol) Versus Intralesional Vitamin D3 in the Treatment of Cutaneous Warts: A Clinical Therapeutic Comparative Trial.

Background: Cutaneous warts are epidermal proliferations caused by human papillomavirus. There are a variety of treatment options for warts with different success rates. Intralesional vitamin D₃ injection is an innovative treatment option for warts, and several studies have examined its efficacy. To the best of our knowledge, this is the first study to compare the two modalities of vitamin D₃ in wart treatment. Objective: To evaluate and compare the efficacy of topical vitamin D₃ derivative (calcipotriol) and intralesional vitamin D₃ in the treatment of warts. Patients and Methods: This is an open-label, therapeutic, comparative, clinical study involving 56 patients with warts. The patients were randomly divided into two equal groups (n = 28). Group A was treated with topical calcipotriol ointment (0.005%) twice daily for a period of 8 weeks, while Group B was treated with intralesional injection of 0.2-0.3 mL of vitamin D₃ (300,000 I.U. per ampule) for 4 sessions (2 weeks apart). The patients were followed every 2 weeks during treatment and then 3 months after the last visit. Results: The percentage of patients who showed a complete response in Group A was higher than that of Group B (95% vs. 59%). Furthermore, 9 patients out of 13 (69.2%) who showed a complete response in Group B required a period of 8 weeks, while only 2 patients out of 21 (9.5%) in Group A required the same period. In addition, side effects were more in Group B. Moreover, no recurrence was observed in Group A, while in Group B, it was seen in 2 (11%) patients. Conclusions: Both topical and intralesional vitamin D₃ are effective in the treatment of warts, with topical vitamin D₃ having better efficacy, faster, less side effects, and less risk of recurrence.