S M Johnson1, P K Roberson, T D Horn. 1. Department of Dermatology, University of Arkansas for Medical Sciences, 4301 W Markham, SLOT 576, Child Study Center Room 124a, Little Rock, AR 72205, USA. johnsonsandram@uams.edu
Abstract
BACKGROUND: Warts are common and induce physical and emotional discomfort. Numerous therapies exist, yet none is optimal. Despite theoretical advantages, immunotherapeutic modalities are often neglected as first-line wart therapies. OBJECTIVE: To compare treatment with intralesional skin test antigen injection of 1 wart vs cryotherapy of all warts. DESIGN: Pilot study. SETTING: University dermatology outpatient clinic. PATIENTS: A total of 115 consecutive patients with at least 1 nongenital wart. INTERVENTIONS: Patients with warts were tested for immunity to mumps and Candida using commercial antigens. Nonresponders received cryotherapy and immune individuals received cryotherapy or intralesional injection of 1 antiserum. RESULTS: Thirty-four (30%) of the 115 patients did not respond to the test injections and 81 (70%) had detectable immunity. Of the immune group, 26 (32%) received cryotherapy, 45 (56%) received intralesional mumps antiserum, and 10 (12%) received intralesional Candida antiserum. Of the anergic patients, 28 (82%) were treated with cryotherapy; 6 (18%) refused cryotherapy. Of the 39 patients who were treated with immunotherapy and completed the protocol, 29 (74%) had complete clearing of the treated wart. Fourteen (78%) of 18 patients with complete resolution of their immunotherapy-treated wart also had resolution of untreated, distant warts. CONCLUSIONS: Intralesional injection of mumps or Candida antigens into warts of immune individuals represents effective treatment. Observation of clearing of anatomically distinct and distant warts suggests acquisition of human papillomavirus-directed immunity in some patients. We conclude that this novel approach to immunotherapy may serve as first-line treatment in immune individuals with multiple or large warts and as second-line treatment in immune patients for whom cryotherapy fails.
BACKGROUND: Warts are common and induce physical and emotional discomfort. Numerous therapies exist, yet none is optimal. Despite theoretical advantages, immunotherapeutic modalities are often neglected as first-line wart therapies. OBJECTIVE: To compare treatment with intralesional skin test antigen injection of 1 wart vs cryotherapy of all warts. DESIGN: Pilot study. SETTING: University dermatology outpatient clinic. PATIENTS: A total of 115 consecutive patients with at least 1 nongenital wart. INTERVENTIONS:Patients with warts were tested for immunity to mumps and Candida using commercial antigens. Nonresponders received cryotherapy and immune individuals received cryotherapy or intralesional injection of 1 antiserum. RESULTS: Thirty-four (30%) of the 115 patients did not respond to the test injections and 81 (70%) had detectable immunity. Of the immune group, 26 (32%) received cryotherapy, 45 (56%) received intralesional mumps antiserum, and 10 (12%) received intralesional Candida antiserum. Of the anergic patients, 28 (82%) were treated with cryotherapy; 6 (18%) refused cryotherapy. Of the 39 patients who were treated with immunotherapy and completed the protocol, 29 (74%) had complete clearing of the treated wart. Fourteen (78%) of 18 patients with complete resolution of their immunotherapy-treated wart also had resolution of untreated, distant warts. CONCLUSIONS: Intralesional injection of mumps or Candida antigens into warts of immune individuals represents effective treatment. Observation of clearing of anatomically distinct and distant warts suggests acquisition of human papillomavirus-directed immunity in some patients. We conclude that this novel approach to immunotherapy may serve as first-line treatment in immune individuals with multiple or large warts and as second-line treatment in immune patients for whom cryotherapy fails.
Authors: Hannah N Coleman; William W Greenfield; Shawna L Stratton; Rita Vaughn; Alexander Kieber; Andrea M Moerman-Herzog; Horace J Spencer; Wilbur C Hitt; Charles Matthew Quick; Laura F Hutchins; Samuel G Mackintosh; Ricky D Edmondson; Stephen W Erickson; Mayumi Nakagawa Journal: Cancer Immunol Immunother Date: 2016-03-15 Impact factor: 6.968
Authors: Joshua A Farhadian; Brook E Tlougan; Brian B Adams; Jonathan S Leventhal; Miguel R Sanchez Journal: Sports Med Date: 2013-07 Impact factor: 11.136
Authors: William W Greenfield; Shawna L Stratton; Rebecca S Myrick; Rita Vaughn; Lisa M Donnalley; Hannah N Coleman; Maria Mercado; Andrea M Moerman-Herzog; Horace J Spencer; Nancy R Andrews-Collins; Wilbur C Hitt; Gordon M Low; Nirvana A Manning; Samantha S McKelvey; Dora Smith; Michael V Smith; Amy M Phillips; C Matthew Quick; Susanne K Jeffus; Laura F Hutchins; Mayumi Nakagawa Journal: Oncoimmunology Date: 2015-05-27 Impact factor: 8.110