A Comparative Study on the Efficacy and Safety Profile of Intralesional MMR Vaccine And Autoimplantation in The Treatment of Periungual Wart

Abstract

Background: Warts are benign epidermal tumors of mucocutaneous surface caused by Human Papilloma Virus. They poses 
a therapeutic challenge to the treating dermatologist, particularly periungual warts. The treatment modalities for periungual 
warts are associated with scarring, disfigurement and deformities. Hence immunotherapy has evolved as an effective, safe 
and inexpensive treatment modality.Objectives: To evaluate the efficacy and safety profile of MMR vaccine in the treatment of periungual warts and to compare it with autoimplantation.Methods: In this randomised controlled study on 40 patients with periungual warts, one group (n = 20) were treated with intralesional MMR vaccine and the second group (n = 20)withautoimplantation.Three treatment sessions were carried out in both groups at an interval of two weeks in MMR group and one month in autoimplantation group. Results were assessed by dermatologist’s objective assessment and patient’s subjective score.Results:  Out of 20 recruited patients in MMR group, 18 (90%) showed complete cure and two (10%) had partial clearance. 
In the autoimplantation group, 11 (55%) had complete cure, two had partial clearance and seven (35%) had no response. 
There was statistically significant difference in the response between the two groups during 2nd and 3rd follow up (p value – 0.006 and 0.015) respectively The mean nConclusion: Intralesional MMR vaccine was found to be more effective compared to autoimplantation as far as the duration of treatment, cost, procedural time and feasibility issues are concernedumber of treatment sessions required for complete cure showed no statistically significant difference.