REVIEW ARTICLE


Wart Immunotherapies: A Short Review



Ryan S. Sefcik1, Craig G. Burkhart2, *
1 University of Toledo, College of Medicine, Toledo, Ohio, OH, USA
2 Department of Medicine, University of Toledo College of Medicine, Toledo; Department of Medicine, Ohio University of Osteopathic Medicine, Athens, Ohio, OH, USA


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© 2017 Sefcik and Burkhart.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University of Toledo, College of Medicine, 5662 Aspen Dr, Toledo, Ohio, OH, 43615; Tel: (330)760-5154; E-mail: rsefcik16@gmail.com


Abstract

Objective:

To review the efficacy and costs of various contact immunotherapies, contact allergens, intralesional immunotherapies, and intralesional cytotoxic agents for the treatment of recalcitrant warts.

Background:

Cutaneous warts are common viral skin lesions caused by human papillomavirus that can be challenging to treat and frustrating for physicians and patients. Although several treatment options exist, there is no single treatment that can ensure a complete response with lack of lesion recurrence. Immunotherapies for recalcitrant warts present as a cost-effective, efficient therapy option for patients. Intralesional approaches have the added benefit of affecting warts at locations distant to the target location by inducing a systemic T-cell mediated response in the body.

Results:

Various contact immunotherapies, contact allergens, intralesional immunotherapies, and intralesional cytotoxic agents have shown to be effective in treating warts. The costs of each treatment varies drastically from around $10 US to over $1000 US to achieve a complete response. Several antigens were found to be both efficacious and cost effective.

Conclusion:

Although efficacy of several antigens has been confirmed by randomized studies, more randomized comparative studies will need to be performed in order to determine the best antigen and correct standardized doses for the treatment of warts in individual patients. It is important to note that individual response to antigen type and dose may vary among patients. Therefore, further studies may play an important role in the use of immunotherapies in a clinical setting.

Keywords: Warts, Immunotherapy, Immunodermatology, Cutaneous lesions, Intralesional, HPV.