Role of some intralesional immune therapeutics in verruca vulgaris

Abstract

Verrucae or warts are benign epidermal growths of the skin and mucosa induced by the human papillomavirus. A range of immunogenic protein antigens has been used intralesionally for treating warts. Each antigen has distinct immunogenic characteristics, and individual patients may exhibit differing reactions to the same antigen. Intralesional administration of vitamin D is an efficient and safe therapy for verruca vulgaris, resulting in elevated expression of cathelicidin LL37. The capacity of 5-Fluorouracil (5-FU) to block DNA and RNA production enables the use of intralesional 5-FU for the management of viral warts. Methotrexate provided a cure rate nearly similar to 5 -FU, but vitamin D provided the least cure rate. Multiple studies have shown the efficacy of intralesional bleomycin for wart therapy, with rates of cure ranging from 14% to 99%. Bleomycin applied to the skin induces keratinocyte apoptosis, endothelial cell sclerosis, and collagen production inhibition.