Tuberculin as Intralesional Therapy for Viral Warts—Single-Blind, Split, Placebo, Controlled Study ()
ABSTRACT
Background:
BCG vaccine as an antigen has proved its effectiveness as an immunotherapy for viral
warts. Tuberculin is an antigenic extract of M. tuberculosis capable of eliciting an immunological skin reaction.
Objective: To assess the efficacy of tuberculin intralesional injection in the treatment
of viral warts. Patients and Methods: This
single ,blind, placebo controlled study was conducted at the Department of Dermatology,
Baghdad Teaching Hospital, Baghdad, Iraq from March 2010 to July 2011.Forty-one
patients with different types of viral warts were enrolled in this study; tuberculin
test was done to patients prior to instillation of intralesional treatment. Then
the patients treated by intralesional tuberculin in each lesion located on the right
side of the body, and intralesional distilled water in each lesion located on the
left side of to a maximum of 3 injections, at 2 weeks interval or until full resolution
of these lesions. Patients were evaluated every 2 weeks to assess the regression
of their lesions and to record any local and systemic adverse effects. The response
to treatment was evaluated by decrease in size and reduction in number of warts. Scoring of response to treatment was as follow: 1) Responders:
including patients who showed complete cure or those with good response (>50%
reduction). 2) Non responders: including patients who showed minimal response (<50%
reduction), or those with no improvement (stable disease and disease progression). The follow up period lasted up to 2 months after the
last dose. Results: Thirty out of 41 patients had completed the study, of them 14
(46.66%) patients showed response of their lesions on the right side of the body
that were treated with tuberculin; 15
patients showed no response, 1 patient showed minimal response, 7 patients showed
good response and 7 patients showed complete cure (23.33%). Regarding the lesions
treated with intralesional distilled water, 25 patients showed no response, 3 patients
showed minimal response, 2(6.66) patients showed good response and no patient showed
complete cure of their warts. Of the 14 responder patients to intralesional tuberculin,
10 patients were tuberculin tested positive, and 4 patients were tested negative,
and of the 16 non responder patients to intralesional tuberculin, 3 patients were
tuberculin tested positive, and 13 patients were tuberculin tested negative which
was statistically significant
difference. No side effects
reported from tuberculin therapy apart from mild pain at site of injection. Conclusion:
Intralesional injection of tuberculin is an effective therapy for viral warts when compared with control, possibly through its local
immunological action and had no systemic immunological response. Patients with previous
BCG vaccine showed better response to tuberculin injection.
Share and Cite:
Sharquie, K. , Al-Rawi, J. , Noaimi, A. and Majly, W. (2016) Tuberculin as Intralesional Therapy for Viral Warts—Single-Blind, Split, Placebo, Controlled Study.
Journal of Cosmetics, Dermatological Sciences and Applications,
6, 191-198. doi:
10.4236/jcdsa.2016.65024.