A study on the efficacy of immunotherapy with purified protein derivative for the treatment of recalcitrant warts

Background: There are many treatment modalities of warts, but most of them are destructive therapies which have propensity to cause scarring. Many antigens especially PPD of tuberculin bacilli are being used for the regression of warts. Objectives: To study the efficacy of twenty five cases of purified protein derivative of tuberculin bacilli for the treatment of warts. Methods: A randomized controlled trial was done in which 25 patients of recalcitrant warts were taken up for the study. In all the patients, 2.5 units of PPD was injected in each wart and upto maximum of 25 units PPD was given and the injections were given every 3 weeks for a total of 3 sessions. Results: Commonest type of wart seen in our study was verruca vulgaris seen in 15(60%) patients, verruca plana seen in 5(20%) patients, palmoplantar warts seen in 3 (12%) patients and genital warts seen in 2 (8%) patients. Regarding the number of warts 15 (60%) patients had more than 20 warts, 5 (20%) patients had number of lesions between 11 – 20 and another 5(20%) patients had lesions between 1 – 10. Complete clearance of lesions after 3 sessions was seen in 18 (72%) patients, partial clearance of lesions was seen in 4 (16%) patients and no response was seen in 3 (12%) patients. Conclusion: Immunotherapy with PPD causes boosting up of the cell mediated immunity of the patients which causes spontaneous regression of the warts.