COMPARISON OF THE EFFICACY OF INTRALESIONAL VITAMIN D3 AND INTRALESIONAL 5 FLUOROURACIL IN TREATMENT OF CUTANEOUS WARTS
DOI:
https://doi.org/10.54112/pjicm.v5i02.131Keywords:
Cutaneous Warts, Intralesional Therapy, 5-Fluorouracil, Vitamin D3, EfficacyAbstract
Background: Cutaneous warts are common benign skin lesions caused by human papillomavirus (HPV) and can be resistant to conventional therapies. Intralesional therapies such as vitamin D3 and 5-fluorouracil (5-FU) have emerged as promising treatment options, yet their comparative efficacy remains under-investigated. Objective: To compare the efficacy of intralesional vitamin D3 and intralesional 5-FU in the treatment of cutaneous warts. Study Design: Randomized controlled trial. Setting: Department of Dermatology, Khyber Teaching Hospital, Peshawar, Pakistan. Duration of Study: 29-September-2024 to 29-March-2025. Methods: A total of 192 patients with clinically diagnosed cutaneous warts were included and randomly assigned into two equal groups. Group A received intralesional vitamin D3 (0.2–0.5 mL of 15 mg/mL) combined with lidocaine-adrenaline, while Group B received intralesional 5-FU (10 units of 250 mg/5 mL) in the same anesthetic solution. Treatment efficacy was defined as >50% reduction in lesion size and number assessed visually. Data were analyzed using appropriate statistical tests, with a p-value <0.05 considered significant. Results: The mean age of participants in Group A was 33.04 ± 11.89 years, while in Group B it was 33.30 ± 11.31 years. The efficacy rate was significantly higher in the 5-FU group (82%) compared to the vitamin D3 group (64%) (p < 0.05). Conclusion: Intralesional 5-FU demonstrated superior efficacy compared to vitamin D3 in the treatment of cutaneous warts, suggesting that 5-FU may be preferred in clinical practice.
References
Loo SK, Tang WY. Warts (non-genital). BMJ Clin Evid. 2014;2014:1710.
Ockenfels HM. Therapeutic management of cutaneous and genital warts. J Dtsch Dermatol Ges. 2016;14(9):892–9. https://doi.org/10.1111/ddg.12838
Al-Awadhi R, Al-Mutairi N, Chehadeh W. Prevalence of HPV genotypes in adult male patients with cutaneous warts: a cross-sectional study. Med Princ Pract. 2020;29(5):458–64. https://doi.org/10.1159/000505599
Bossart S, Daneluzzi C, Moor MB, Hirzel C, Heidemeyer K, Seyed Jafari SM, et al. HPV vaccination in immunosuppressed patients with established skin warts and non-melanoma skin cancer: a single-institutional cohort study. Vaccines. 2023;11(9):1490. https://doi.org/10.3390/vaccines11091490
Ringin SA. The effectiveness of cutaneous wart resolution with current treatment modalities. J Cutan Aesthet Surg. 2020;13(1):24–30. https://doi.org/10.4103/JCAS.JCAS_62_19
Al-Eitan LN, Alghamdi MA, Tarkhan AH, Al-Qarqaz FA. Genome-wide identification of methylated CpG sites in nongenital cutaneous warts. BMC Med Genomics. 2020;13(1):100. https://doi.org/10.1186/s12920-020-00745-6
Menzies SW, Emery J, Staples M, et al. Impact of dermoscopy and short-term sequential digital dermoscopy imaging for the management of pigmented lesions in primary care: a sequential intervention trial. Br J Dermatol. 2009;161(6):1270–7. https://doi.org/10.1111/j.1365-2133.2009.09374.x
Binder M, Schwarz M, Winkler A. Epiluminescence microscopy: a useful tool for the diagnosis of pigmented skin lesions for formally trained dermatologists. Arch Dermatol. 1995;131(3):286–91. https://doi.org/10.1001/archderm.131.3.286
Jones OT, Jurascheck LC, Utukuri M, Pannebakker MM, Emery J, Walter FM. Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology. J Eur Acad Dermatol Venereol. 2019;33(9):1706–12. https://doi.org/10.1111/jdv.15614
Blum A. Some thoughts on the ‘three-point checklist of dermoscopy’. Dermatology. 2004;209(2):167. https://doi.org/10.1159/000079605
Bafounta ML, Beauchet A, Aegerter P, Saiag P. Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol. 2001;137(10):1343–50. https://doi.org/10.1001/archderm.137.10.1343
Fatima K, Butt MN, Javaid S, Bhatti RZ, Rasheed RA. Efficacy and safety of intralesional 5-fluorouracil in treatment of warts. Indus J Biosc Res. 2025;3(3):352–5. https://doi.org/10.70749/ijbr.v3i3.865
Al-Sabak H, Al-Hattab M, Al-Rammahi M, Al-Dhalimi M. The efficacy of intralesional vitamin D3 injection in the treatment of cutaneous warts: a clinical therapeutic trial study. Skin Res Technol. 2023;29(8):e13442. https://doi.org/10.1111/srt.13442
Gupta S, Chahar YS, Singh K, Kharabanda A. Comparative study to evaluate the efficacy of intralesional 5-fluorouracil versus intralesional vitamin D3 in management of cutaneous warts. Int J Curr Adv Res. 2024;13(3):2904–8. https://doi.org/10.24327/ijcar.2023.2908.1633
Kamal T, Ahmad F, Iftikhar U. Efficacy and safety of intralesional 5-fluorouracil in treatment of warts. J Pak Assoc Dermatol. 2018;28(3):337–9. JPAD
Bdaiwi SA, Abdul-Saheb RH. Variation in the outcome following intralesional 5-FU in the treatment of various forms of cutaneous warts in Iraqi patients based on clinical presentation. Iran J War Public Health. 2021;13(4):235–8. Iranian Journal of War and Public Health
Shaikh RB, Shaikh IA, Shaikh SH, Shaikh SM. Efficacy and safety of intralesional 5-fluorouracil in the treatment of cutaneous warts. 2025;3(5):963–8.
Yazdanfar A, Farshchian M, Fereydonnejad M, Farshchian M. Treatment of common warts with an intralesional mixture of 5-fluorouracil, lidocaine, and epinephrine: a prospective placebo-controlled, double-blind randomized trial. Dermatol Surg. 2008;34(5):656–9. https://doi.org/10.1111/j.1524-4725.2007.34123.x
Aktas H, Ergin C, Demir B, Ekiz Ö. Intralesional vitamin D injection may be an effective treatment option for warts. J Cutan Med Surg. 2016;20(2):118–22. https://doi.org/10.1177/1203475415602841
Raghukumar S, Ravikumar BC, Vinay KN, Suresh MR, Aggarwal A, Yashovardhan DP. Intralesional vitamin D3 injection in treatment of recalcitrant warts: a novel proposition. J Cutan Med Surg. 2017;21(4):320–4. https://doi.org/10.1177/1203475417704180
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