Abstract
BACKGROUND AND AIMS: Intralesional immunotherapy is an upcoming method of wart treatment with fewer side effects and this study aims to assess and compare the efficacy of intralesional MMR vaccine and vitamin D3 in the treatment of nongenital warts. METHODS: A comparative prospective study was done with a total of 61 patients divided into two groups. Thirty-one patients were treated with intralesional MMR, while 30 patients received intralesional vitamin D3. In both groups, a maximum of five sessions were carried out every 3 weeks and follow-up was done for 3 months. χ (2), Fisher's exact, and multivariate analyses assessed variable relationships. RESULTS: In the MMR group, 80.6% of patients achieved complete response, 6.5% had excellent response, 9.7% showed good response, and 3.2% had no response. Similarly, in the vitamin D3 group, 73.4% achieved complete response, 20.0% had excellent response, 3.3% showed good response and 3.3% had no response. The difference in response rates between the two groups was statistically insignificant. One patient (4.0%) in the MMR group and three patients (13.6%) in the vitamin D3 group experienced recurrence within 3 months of follow-up, but this difference was not statistically significant. Both treatments were well tolerated. Pain was universal, while swelling (60%), hyperpigmentation (30%), and pruritus (16.7%) were more common with vitamin D3. In logistic regression analysis, pain duration was significantly higher in the Vitamin D group compared to the MMR group (p < 0.001). Fever (MMR) and hypervitaminosis D3-related fatigue (vitamin D3) were rare. No severe adverse events occurred. CONCLUSIONS: Both intralesional MMR and vitamin D3 showed positive response and were well tolerated and comfortable modalities for the treatment of warts. However, recurrence rate and side effects were higher with Vitamin D3 than MMR. Clinicaltrials.gov: NCT04428359.