Vitamina D para verrugas vulgares

Published in Dermatology

Journal Scan / Research · May 31, 2017

Intralesional Vitamin D3 Injection Helpful in the Treatment of Recalcitrant Warts

BACKGROUND

Verruca vulgaris (viral warts) is a fairly common condition with a plethora of treatment options having variable success rates. Recalcitrant warts are refractory to treatment with often disappointing response and high recurrence rates. Lately, treatment with intralesional injections has gained momentum due to its effectiveness in clearing warts by stimulating the cell-mediated immunity. Vitamin D, when applied topically, regulates epidermal cell proliferation and is involved in the formation of antimicrobial peptides. We have attempted to use vitamin D3 to exploit its reported action as an immunotherapeutic molecule in addition to its topical effects. To our knowledge, there are no reports of intralesional vitamin D3 injections used in the treatment of extragenital recalcitrant warts.

METHODS

Sixty-four patients with recalcitrant warts of varying sizes and duration were included in the study. About 0.2- to 0.5-mL vitamin D3 solution (600,000 IU, 15 mg/mL) was injected to the base of the wart. A maximum of 5 warts were injected per session at 3-week intervals until resolution or for a maximum of 4 treatments. Patients were followed up for 6 months after the last injection to detect any recurrence.

RESULTS

Sixty patients completed the study. Complete response was seen in 54 of 60 (90%), partial response in 4 of 60 (6.66%), and no response in 2 of 60 (3.33%). The average number of injections required to achieve a complete resolution was 3.66. Complete resolution of distant warts was noticed in all patients.

CONCLUSIONS

Intralesional vitamin D3 is a safe, effective, and an inexpensive treatment option for recalcitrant warts.

TAKE-HOME MESSAGE

• In this study, intralesional injections of 0.2- to 0.5-mL vitamin D3 solution (600,000 IU; 15 mg/mL) at 3-week intervals were used to treat recalcitrant warts in 60 patients. The majority of patients (90%) had complete response. Of the remaining patients, 6.66% showed partial response and 3.33% showed no response. Complete resolution required an average of 3.66 injections. Of the 35% of patients with distant warts, all experienced complete resolution of these in addition to resolution of the primary lesion.

• This study showed for the first time that intralesional injections of vitamin D3, which regulates cell proliferation and antimicrobial peptide formation, may be used in the treatment of extragenital recalcitrant warts.

  – InYoung Kim, MD, PhD

Journal of cutaneous medicine and surgery

Intralesional Vitamin D3 Injection in the Treatment of Recalcitrant Warts: A Novel Proposition

J Cutan Med Surg 2017 Apr 06;[EPub Ahead of Print], S Raghukumar, BC Ravikumar, KN Vinay, MR Suresh, A Aggarwal, DP Yashovardhana