N B Silverberg1, J K Lim, A S Paller, A J Mancini. 1. Department of Pediatrics and Dermatology, Northwestern University Medical School, Children's Memorial Hospital, Chicago, IL 60614, USA.
Abstract
BACKGROUND: Warts are a common pediatric skin infection caused by human papillomavirus (HPV). Spontaneous clearance of warts involves anti-HPV immunity, which may be enhanced by contact sensitizers. Squaric acid dibutylester (SADBE) is a nonmutagenic sensitizing agent useful for immunotherapy of alopecia areata. OBJECTIVE: We hypothesized that SADBE home application might be effective therapy for warts. METHODS: An open-label, retrospective study of 61 children with warts was performed. Sensitization with 2% SADBE on the forearm was followed with home application of 0.2% SADBE to warts 3 to 7 nights per week for at least 3 months. RESULTS: Complete clearing occurred in 34 patients (58%), with a mean duration of therapy of 7 weeks. Partial clearing occurred in 11 (18%), and no response in 14 (24%). Clearance correlated with plantar distribution, wart duration under 2 years (P <.05), and first-line therapy with SADBE. Mild side effects occurred in one third of patients, were limited most commonly to mild erythema at the site of sensitization, and necessitated discontinuation of therapy in only 2 patients. CONCLUSION: SADBE topical immunotherapy is a safe, effective option for home therapy of warts in children.
BACKGROUND: Warts are a common pediatric skin infection caused by human papillomavirus (HPV). Spontaneous clearance of warts involves anti-HPV immunity, which may be enhanced by contact sensitizers. Squaric acid dibutylester (SADBE) is a nonmutagenic sensitizing agent useful for immunotherapy of alopecia areata. OBJECTIVE: We hypothesized that SADBE home application might be effective therapy for warts. METHODS: An open-label, retrospective study of 61 children with warts was performed. Sensitization with 2% SADBE on the forearm was followed with home application of 0.2% SADBE to warts 3 to 7 nights per week for at least 3 months. RESULTS: Complete clearing occurred in 34 patients (58%), with a mean duration of therapy of 7 weeks. Partial clearing occurred in 11 (18%), and no response in 14 (24%). Clearance correlated with plantar distribution, wart duration under 2 years (P <.05), and first-line therapy with SADBE. Mild side effects occurred in one third of patients, were limited most commonly to mild erythema at the site of sensitization, and necessitated discontinuation of therapy in only 2 patients. CONCLUSION: SADBE topical immunotherapy is a safe, effective option for home therapy of warts in children.
Authors: Yeon Sook Choi; Tal H Erlich; Max von Franque; Inbal Rachmin; Jessica L Flesher; Erik B Schiferle; Yi Zhang; Marcello Pereira da Silva; Alva Jiang; Allison S Dobry; Mack Su; Sharon Germana; Sebastian Lacher; Orly Freund; Ezra Feder; Jose L Cortez; Suyeon Ryu; Tamar Babila Propp; Yedidyah Leo Samuels; Labib R Zakka; Marjan Azin; Christin E Burd; Norman E Sharpless; X Shirley Liu; Clifford Meyer; William Gerald Austen; Branko Bojovic; Curtis L Cetrulo; Martin C Mihm; Dave S Hoon; Shadmehr Demehri; Elena B Hawryluk; David E Fisher Journal: Cell Date: 2022-05-12 Impact factor: 66.850