Comparative Study Among CO2 Laser, Intralesional Vitamin D3, and Combined Intralesional Vitamin D3 and CO2 Laser in Treatment of Palmoplantar Warts

Abstract

BACKGROUND Many therapeutic modalities are used for palmoplantar warts; whether destructive, such as chemical cautery, electrocautery, cryocautery, surgical removal, and laser ablation, or immunotherapeutic, stimulating the immune system against the virus such as intralesional vitamin D3 injection. OBJECTIVE To compare the efficacy of intralesional vitamin D injection combined with CO2 laser to the efficacy of either modality alone. PATIENT AND METHODS Eighty age- and sex-matched patients with palmoplantar warts were divided into 4 groups: Group A received intralesional vitamin D3 injections, group B received ablative CO2 laser, group C received CO2 laser and intralesional vitamin D3 injection, and group D (control group) were injected intralesionally with normal saline. Assessment was performed clinically, photographically, and dermoscopically before and after treatment to evaluate the response, and then, another assessment was performed after 3 months to detect any recurrence. RESULTS Complete clearance was seen in 90% of cases in group C, in 80% in group A, and in 75% in group B with no statistically significant difference. CONCLUSION Intralesional vitamin D, CO2 laser, and the combination show comparable efficacy and recurrence rates. Intralesional vitamin D maybe a better option for people with a relative contraindication to CO2 laser.