Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh

Abstract Introduction: Warts are the viral infection of the skin caused by Human Papilloma Virus occurring in form of verrucous growth over the surface of the skin. Incomplete removal or local recurrence of the infection is the disadvantage with the currently available local tissue destructive therapies. Newer therapy i.e. intralesional immunotherapy with purified protein derivative offers the advantage of taking care of viral infection not only at treatment site but also at the remote site and also offers life long immunity. Materials and Methods: The study was conducted on 51 patients of warts of all ages at LLRM Medical College, Meerut. After clinical examination, patients were given 0.1 ml of 5 TU of PPD intralesionally in the largest wart at an interval of one week for six weeks. Patient’s assessment in follow up visits was done with clinical photographs and by filling proforma for effects and side effects. Results: Complete clearance was seen in 35(68.6%) patients, partial clearance in 6(11.7%) patients, and no clearance in 10(19.6%) patients. The variation in response in different morphologic type of warts was as follows: Periungual and palmar wart 100% clearance, plantar wart 78.5% clearance, verruca plana 60% clearance and verruca vulgaris showed 47% clearance. Conclusion: PPD immunostimulation is worth in all types of warts. It can be used as a valuable first line treatment in difficult to treat sites like palmoplantar wart and periungual wart. Keywords: Wart, PPD, Immunotherapy. Introduction Warts are the viral infection of the skin caused by Human Papilloma virus, which manifest in the form of verrucous growth over the surface of skin. HPV is a DNA virus that infects skin or mucosal cells. It infects the basal layer of epithelium, possibly the stem cells, but viral replication takes place only in fully differentiated keratinocytes i.e. cells of the stratum spinosum and stratum granulosum. All papilloma virus types have a