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

Background:Several treatment options exist for warts. Destructive approaches ''although the most common'' are sometimes inconvenient especially for large and multiple warts, leaving wide areas of raw skin that takes time to heal with increased liability to infection.Thus, immunotherapy emerged as a better treatment option for resistant warts.Various agents have been used for enhancing the immune response, including oral zinc, interferons, H2 receptor blockers, intralesional injection of MMR vaccine, Candida antigen, PPD and BCG. Imiquimod and DPC have shown efficacy, as well.Both arms of adaptive immunity, cell mediated and humoral immune systems appear to be influenced by zinc. It is expected to promote Th1 cytokine response with further activation of cytotoxic T cells and natural killer cells, subsequently eradicating HPV infected cells. Aim of work:To assess whether adding oral zinc to either intralesional MMR or electrosurgery of single targeted wart would enhance a therapeutic response in distant warts. Patient and Methods:40 patients with multiple common warts were first tested for existing immunity.Twenty patients with positive sensitivity test were enrolled into either of theIL MMR groups; ILMMR group (A) or ILMMR with oral zinc group (B). The other twenty patients were allocated into either of electrosurgery groups; electrosurgery of a single wart (C) or electrosurgery of a single wart with oral zinc (D)

Issued also as CD