Intralesional injection of mumps or Candida skin test antigens: a novel immunotherapy for warts.

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.

• Authors: S M Johnson, P K Roberson, T D Horn
• Journal: Archives of dermatology (Arch Dermatol) Vol. 137 Issue 4 Pg. 451-5 (Apr 2001) ISSN: 0003-987X [Print] United States
• PMID: 11295925 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antigens, Fungal
• Antigens, Viral
• Immune Sera

Topics

• Adolescent
• Adult
• Aged
• Antigens, Fungal (administration & dosage)
• Antigens, Viral (administration & dosage)
• Candida (immunology)
• Child
• Child, Preschool
• Cryotherapy
• Data Interpretation, Statistical
• Female
• Follow-Up Studies
• Humans
• Immune Sera (administration & dosage)
• Immunization, Passive
• Immunotherapy
• Injections, Intralesional
• Male
• Middle Aged
• Mumps virus (immunology)
• Pilot Projects
• Time Factors
• Warts (immunology, therapy)