Indian Journal of Paediatric Dermatology (Jan 2019)

Evaluation of efficacy and safety of intralesional Measles-Mumps-Rubella virus vaccine for the treatment of common warts in children and adolescents

  • Vikram K Mahajan,
  • Pushpinder Singh Chauhan,
  • Aditi Sharma,
  • Karaninder Singh Mehta,
  • Ritu Rawat,
  • Vikas Sharma

DOI
https://doi.org/10.4103/ijpd.IJPD_106_18
Journal volume & issue
Vol. 20, no. 3
pp. 231 – 235

Abstract

Read online

Background: No single treatment for warts has proven 100% efficacy and most therapeutic modalities remain unsatisfactory. Immunotherapy with Measles-Mumps-Rubella (MMR) vaccine remains underevaluated, especially in children. Objective: To evaluate the efficacy and safety of intralesional MMR vaccine in the treatment of common warts in children. Materials and Methods: Fifty-five (36 boys and 19 girls) children aged 5–18 (mean ± standard deviation 12.8 ± 3.88) years with common warts received 0.25 ml of MMR vaccine injected intralesionally in the largest wart. The dose was repeated at 2-week interval until complete clearance or for a maximum of 5 doses. Thereafter, they were followed up once a month for 24-week study period. The response was evaluated as complete clearance (complete disappearance of the wart(s) including distant ones and appearance of normal skin), partial clearance (≤99% reduction in size and number including distant ones and few residual warts still visible), good response (some reduction in size only including that of distant ones but no decrease in number of warts), or poor response (no change in size and number). Results: Only 46 patients completed the study and 27 (58.7%) of them had complete clearance of warts, 9 (19.6%) showed partial clearance and 10 (21.3%) patients showed no response. In 15 of 27 patients complete clearance was achieved after 5 doses, 7 had complete clearance after 4 doses and 2 patients each showed complete clearance after 2 and 3 doses, respectively. Conclusion: Intralesional MMR vaccine immunotherapy appears promising, effective, and safe treatment for common warts in children with the advantage of single-lesion infiltration, and resolution without scarring or pigmentary changes commonly seen with destructive therapies. However, better designed larger controlled studies are warranted.

Keywords