September 12, 2021 Intralesional Acyclovir for Cutaneous Warts Journal of Cutaneous Medicine and Surgery

TAKE-HOME MESSAGE

• Patients with warts were treated with intralesional injections of acyclovir or saline into the base of each wart at 2-week intervals for a maximum of 5 sessions. The most common type of wart was common warts (45.1%), followed by plantar warts (41.9%), and periungual warts (12.9%). Complete and partial clearance was seen in 52.6% and 36.8% of acyclovir-treated patients, respectively. Partial response was noted in 16.7% of saline-treated patients. Injection pain occurred in the majority of acyclovir-treated patients and blistering occurred in over half of patients.

• Intralesional acyclovir appears to be an effective treatment for cutaneous warts.

–  Kelly B. Scarberry, MD

Abstract

BACKGROUND

The treatment of warts is challenging and the development of an antiviral drug that can eradicate the human papilloma virus (HPV) is difficult. The viral origin of warts suggests that acyclovir, an antiviral drug with a proven efficacy in DNA viruses, may be a potential therapeutic option.

AIM

To evaluate the efficacy and safety of intralesional acyclovir in the treatment of cutaneous warts.

METHODS

Thirty-one patients with cutaneous warts were allocated into 2 groups. Group A (19 patients) had intralesional acyclovir (70 mg/ml) injected into the warts, while group B (12 patients) received intralesional saline as control. The treatment was repeated at 2 week intervals until complete clearance or for a maximum of 5 sessions.

RESULTS

Complete clearance of warts was observed in 52.6%, partial response in 36.8%, and no response in 10.5% of the patients in the acyclovir group. Partial response was reported in 16.7%, and no response in 83.3% of the patients in the control group. A high statistically significant difference was found between the treatment and control groups (P < .01). Adverse effects included pain during injection in 89.5%, blistering in 52.6% and erythema in5.3% of the patients. No recurrence was detected during the follow-up period.

CONCLUSION

Intralesional acyclovir can be an effective and well-tolerated treatment modality for cutaneous warts.

Journal of Cutaneous Medicine and Surgery

Intralesional Acyclovir: A Potential Therapeutic Option for Cutaneous Warts

J Cutan Med Surg 2021 Aug 19;[EPub Ahead of Print], A Elsayed, A Nassar, A Marei, HAM Hoseiny, R Alakad