Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Dermatology and Venerology

Background: Many therapeutic modalities are employed either alone or in combination for the treatment of palmoplantar warts.These treatment modalities are either destructive such as chemical cautery, electrocautery, cryocautery, surgical removal, and laser ablation; or immunotherapeutic modalities, which activate the immune system against the virus and suppress its activity such as intralesional candida antigen or vitamin D3 injection. Aim of work: To compare the efficacy of intralesional vitamin D injection combined with CO2 laser to the efficacy of either modality alone in the treatment of palmoplantar warts and their recurrence rate. Patients and Methods: Eighty age and sex matched patients with palmo- plantar warts who attended the outpatient Clinic of the Dermatology Department at Kasr Al-Ainy hospital were enrolled in the study. Patients were divided into 4 groups: Group A (vitamin D3 group) received intralesional injection of vitamin D3, group B (CO2 Laser group) received ablative CO2 Laser, group C (combined CO2 Laser and vitamin D3 group) received CO2 laser followed by intralesional injection vitamin D3 and group D (control group) were injected intralesionally with normal saline. Assessment was done clinically, photographically and dermoscopically before and after treatment to evaluate the response then another assessment was done after 3 months to detect any recurrence. Results: There was a statistically significant difference between the control group on one hand and the other groups on the other hand regarding the degree of response (p=0.000*). On comparing the 3 groups A, B and C, no statistically significant difference was noted regarding the degree of response, complete improvement time and incidence of recurrence. However, the incidence of side effects was significantly less in the laser only group (B) when compared to the other groups

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