Intralesional immunotherapy for pediatric warts: A review

Cutaneous warts are a common pediatric complaint with modest response to first‐line treatments. Warts are a manifestation of human papillomavirus (HPV) infection and are cleared by cell‐mediated immunity (CMI). Intralesional immunotherapy treatments have been studied as alternative therapies, partic...

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Bibliographic Details
Published in:Pediatric dermatology 2020-03, Vol.37 (2), p.265-271
Main Authors: Fields, Jaime R., Saikaly, Sami K., Schoch, Jennifer J.
Format: Article
Language:English
Subjects:
Antigens
Bacillus Calmette-Guerin vaccine
BCG
Combined vaccines
Human papillomavirus
Humans
Immunotherapy
Injections, Intralesional
intralesional
Measles
Mumps
pediatric
Pediatrics
Rubella
Tuberculin
Vaccines
verruca
Warts
Warts - therapy
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Summary:Cutaneous warts are a common pediatric complaint with modest response to first‐line treatments. Warts are a manifestation of human papillomavirus (HPV) infection and are cleared by cell‐mediated immunity (CMI). Intralesional immunotherapy treatments have been studied as alternative therapies, particularly for recalcitrant or multiple warts, including Candida antigen, mumps antigen, the combined measles, mumps, and rubella (MMR) vaccine, tuberculin purified protein derivative (PPD), and bacille Calmette‐Guerin (BCG) vaccine. These treatments are thought to increase HPV recognition by stimulating CMI. In this review, we evaluate and compare the efficacy and adverse effects of intralesional immunotherapy in the treatment of pediatric warts. Articles met inclusion criteria if they specifically evaluated the effects of intralesional immunotherapy (candida, MMR, tuberculin PPD, or BCG) as treatment for cutaneous warts in a pediatric population, and if they quantified treatment effect in a reproducible manner. Twenty‐one studies met criteria. Many studies demonstrated complete clearance of injected common warts in pediatric patients with clearance rates ranging from 23.3% to 95.2%. Distant wart resolution was common. Intralesional immunotherapy is a promising treatment option for cutaneous warts in children.
ISSN:0736-8046
1525-1470
DOI:10.1111/pde.14094