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Youssef EMK, Eissa MAA, Bakr RM. Intralesional Candida albicans antigen versus intralesional zinc sulfate in treatment of cutaneous warts. Arch Dermatol Res 2022; 315:1305-1314. [PMID: 36567351 DOI: 10.1007/s00403-022-02499-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/16/2022] [Accepted: 12/01/2022] [Indexed: 12/27/2022]
Abstract
Immunotherapy represents a promising therapeutic option for treatment of warts. Different concentrations of Candida antigen (1/100 and 1/1000) and zinc sulfate 2% were not previously compared regarding their efficacy in treatment of cutaneous warts. The present study compared the safety and efficacy of intralesional candida antigen versus intralesional 2% zinc sulfate for treatment of cutaneous warts. This prospective controlled clinical trial included one hundred and five patients presented with common, plantar, and plane warts. Patients were divided randomly into three groups, each group included 35 patients. Group 1 were treated with intralesional candida antigen (Ag) 1/100, Group 2 were treated with intralesional candida Ag 1/1000, and Group 3 were treated with intralesional zinc sulfate 2%. This study found that target warts of group 1 displayed higher rate of complete clearance compared to group 2 and group 3 (94.3%, 77.1, 74.2%), respectively. The present study concluded that intralesional immunotherapy with Candida antigen was more effective than Intralesional 2% zinc sulfate in treatment of cutaneous warts and less painful. Clinical trial registration number is (Clinical Trials.gov Identifier: NCT03158168).
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Affiliation(s)
- Eman M Kamal Youssef
- Department of Dermatology, Faculty of Medicine, Assiut University, Asyût, Egypt.
| | | | - Radwa M Bakr
- Department of Dermatology, Faculty of Medicine, Assiut University, Asyût, Egypt
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Awad A, Ismael AF, Sallam M, Abdelgaber S. Intralesional Purified Protein Derivative Versus Zinc Sulfate 2% in the Treatment of pediatric warts: Clinical and Dermoscopic Evaluation. J Cosmet Dermatol 2022; 21:4637-4645. [PMID: 35212136 DOI: 10.1111/jocd.14876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Warts are common in children and can be difficult to treat. Many treatments for warts are destructive and painful in contrast to intralesional immunotherapy using different types of antigens. AIM to evaluate the efficacy, safety, and tolerability of intralesional purified protein derivative (PPD) versus intralesional zinc sulfate 2% in the treatment of pediatric warts. METHODS This randomized clinical trial included 120 children with multiple warts divided into two equal groups. Group Ⅰ received intralesional 10 IU (0.1 ml) of PPD, group Ⅱ received intralesional zinc sulfate 2% in the largest wart every 2 weeks till improvement or for a maximum five treatment sessions. The follow up period was 6 months after the last treatment session. RESULTS the overall response was equal in both groups (81.7%), but the response of the injected wart was higher in the zinc sulfate group (93.4%) versus PPD group (83.3%) with no significant difference. The highest cure rates were after the 5th session in the PPD group and the 1st session in the zinc sulfate group with slightly lower numbers of sessions needed for cure in the zinc sulfate group (3 sessions) versus the PPD group (4 sessions). The zinc sulfate group showed statistically significant higher rates of complications (pain, inflammation, necrosis, and scar) than PPD group. The zinc sulfate group showed non-significant higher rates of recurrence during the follow up period. CONCLUSION Both intralesional PPD and zinc sulfate 2% are effective in pediatric warts with higher safety profile of PPD.
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Affiliation(s)
- Amany Awad
- Dermatology, Andrology and STDs department- Faculty of medicine - Mansoura university
| | - Ahmed Fawzi Ismael
- Dermatology, Andrology and STDs department- Faculty of medicine - Mansoura university
| | - Manar Sallam
- Dermatology, Andrology and STDs department- Faculty of medicine - Mansoura university
| | - Soheir Abdelgaber
- Dermatology, Andrology and STDs department- Faculty of medicine - Mansoura university
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Sakhiya J, Sakhiya D, Kaklotar J, Hirapara B, Purohit M, Bhalala K, Daruwala F, Dudhatra N. Intralesional Agents in Dermatology: Pros and Cons. J Cutan Aesthet Surg 2021; 14:285-295. [PMID: 34908770 PMCID: PMC8611707 DOI: 10.4103/jcas.jcas_109_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Since introduced in 1961, intralesional (IL) agent has become an essential part of the dermatological practice. The term IL referred to the direct delivery of agent percutaneously into skin lesions. This therapeutic approach is relatively safe, easy to perform and applicable for a broad range of dermatological conditions. On the other hand, immediate side effects, including pain during administration, bleeding, high risk of infection and allergic reaction, and subsequent side effects involving skin changes such as atrophy, telangiectasia, pigmentary changes, and striae are usually associated with this modality. This review paper highlights the pros and cons of IL agents in modern dermatology practice.
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Affiliation(s)
- Jagdish Sakhiya
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Dhruv Sakhiya
- B.J. Medical College, New Civil Hospital Asarwa, Ahmedabad, Gujarat, India
| | - Jitesh Kaklotar
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Bansi Hirapara
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Madhav Purohit
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Krishna Bhalala
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Feral Daruwala
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Nimish Dudhatra
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
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Fathy G, Abo-Elmagd WM, Afify AA. Intralesional combined digoxin and furosemide in plantar warts: Does it work? J Cosmet Dermatol 2021; 20:2606-2611. [PMID: 33389796 DOI: 10.1111/jocd.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/28/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Warts are small, benign growths caused by human papilloma virus. No treatment has yet proven 100% effective for a cure. DNA viruses rely on K + influx for replication. Both digoxin and furosemide inhibit the K + influx by interacting with cell membrane ion co-transporters. Therefore, it is hypothesized that these two compounds may be valuable in the treatment of warts. AIMS Our aim was to evaluate the efficacy and safety of intralesional injection of a combination of digoxin and furosemide in treatment of plantar warts. PATIENTS/METHODS This two-armed single blinded randomized clinical trial included 40 cases with multiple plantar warts (≥3warts) divided into 2 groups (20 cases each). The first group received intralesional normal saline and the second group received intralesional combined digoxin and furosemide, one session every week for maximum 5 injection sessions. RESULTS On comparing between the 2 groups regarding response to treatment (reduction in number of warts), the first group showed no change in number of warts (82 warts before and after treatment), whereas, in the second group, the number of warts before treatment was 80 while after treatment it was 40 (50% reduction in number). There was a statistically significant difference between the two groups as regard the change in the total number of warts (P < .001). CONCLUSIONS Intralesional injection of combined digoxin and furosemide is safe and effective treatment option in multiple plantar warts.
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Affiliation(s)
- Ghada Fathy
- Dermatology Department-Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Korkmaz S, Şirin FB, Erturan I, Büyükbayram HI, Yildirim M. Coenzyme Q10, Zinc and MDA levels in verruca vulgaris. Turk J Med Sci 2020; 50:1387-1392. [PMID: 31999408 PMCID: PMC7491259 DOI: 10.3906/sag-1909-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background/aim Verruca vulgaris is a benign disease characterized with papillomas on the skin and mucosa. The aim of this study was to investigate the serum levels of coenzyme Q10, MDA, and zinc as well as the lipid profile of verruca vulgaris patients and examine the relationship between these parameters and clinical manifestations of the disease. Materials and methods The study included 49 verruca vulgaris patients (mean age: 32.01 ± 14.20 years; 22 males, 27 females) and 40 healthy volunteers (mean age: 31.63 ± 8.98 years; 21 males and 19 females). Coenzyme Q10 levels were assessed by using an enzyme-linked immunosorbent assay. Serum MDA levels were measured spectrophotometrically. Zinc levels were measured using a Perkin Elmer AAnalyst 800 atomic absorption spectrometer with a deuterium background correction and additional standard techniques. Results The coenzyme Q10 levels were found to be higher in the verruca vulgaris group compared to the healthy volunteers. However, this increase was not statistically significant (P = 0.195). Zinc levels were significantly lower in the verruca vulgaris group compared to the healthy volunteers (P = 0.002). In the patient group, MDA levels and HDL levels were significantly higher compared to the healthy volunteers (P = 0.023 and P = 0.004, respectively). Additionally, there was no statistically significant difference between the groups in the CoQ10/Total cholesterol ratio (P = 0.433). Conclusion Reduced serum zinc levels and increase of oxidative stress in verruca vulgaris may be a factor responsible for development of verruca vulgaris.
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Affiliation(s)
- Selma Korkmaz
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Fevziye Burcu Şirin
- Department of Biochemistry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Ijlal Erturan
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | | | - Mehmet Yildirim
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
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El Sayed MH, Sayed FS, Afify AA. Intralesional zinc sulfate 2% vs intralesional vitamin D in plantar warts: A clinicodermoscopic study. Dermatol Ther 2020; 33:e13308. [DOI: 10.1111/dth.13308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Mahira H. El Sayed
- Department of Dermatology, Venereology, and Andrology, Faculty of Medicine Ain Shams University Cairo Egypt
| | - Fatma S. Sayed
- Ain Shams University Cairo Egypt
- Dermatology resident Ministry of Health Cairo Egypt
| | - Ahmed A. Afify
- Department of Dermatology, Venereology, and Andrology, Faculty of Medicine Ain Shams University Cairo Egypt
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Songsantiphap C, Asawanonda P. Topical 15% Zinc Oxide Ointment Significantly Reduces the Size of Common Warts After Four Weeks: A Randomized, Triple-blinded, Placebo-controlled Trial. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:26-31. [PMID: 31641414 PMCID: PMC6777697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: There are limited number of topical agents for the treatment of common warts. Few reports show efficacy of zinc oxide for such indication. Objectives: We sought to evaluate the efficacy of topical 15% zinc oxide ointment for the reduction in size of common warts. Materials and Methods: Sixteen patients with two comparable palmar warts or verruca vulgaris were randomized to receive either 15% zinc oxide ointment or placebo three times a day for four weeks. Diameter, surface area, and volume change of warts in both groups were used as objective assessments, while patient and physician assessments were also recorded. Results: At Week 4, zinc oxide significantly reduced the median surface area compared to baseline (P<0.037). However, when the median percent changes between groups were compared, there were no statistically significant differences. Conclusions: Zinc oxide can reduce the size of common hand warts after four weeks. We suggest that it can be used as an adjunctive therapy to enhance the efficacy of other treatments.
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Affiliation(s)
- Chankiat Songsantiphap
- Drs. Songsantiphap and Asawanonda are with the Division of Dermatology in the Department of Medicine at Chulalongkorn University in Bangkok, Thailand
| | - Pravit Asawanonda
- Drs. Songsantiphap and Asawanonda are with the Division of Dermatology in the Department of Medicine at Chulalongkorn University in Bangkok, Thailand
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Read SA, Obeid S, Ahlenstiel C, Ahlenstiel G. The Role of Zinc in Antiviral Immunity. Adv Nutr 2019; 10:696-710. [PMID: 31305906 PMCID: PMC6628855 DOI: 10.1093/advances/nmz013] [Citation(s) in RCA: 385] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 12/16/2022] Open
Abstract
Zinc is an essential trace element that is crucial for growth, development, and the maintenance of immune function. Its influence reaches all organs and cell types, representing an integral component of approximately 10% of the human proteome, and encompassing hundreds of key enzymes and transcription factors. Zinc deficiency is strikingly common, affecting up to a quarter of the population in developing countries, but also affecting distinct populations in the developed world as a result of lifestyle, age, and disease-mediated factors. Consequently, zinc status is a critical factor that can influence antiviral immunity, particularly as zinc-deficient populations are often most at risk of acquiring viral infections such as HIV or hepatitis C virus. This review summarizes current basic science and clinical evidence examining zinc as a direct antiviral, as well as a stimulant of antiviral immunity. An abundance of evidence has accumulated over the past 50 y to demonstrate the antiviral activity of zinc against a variety of viruses, and via numerous mechanisms. The therapeutic use of zinc for viral infections such as herpes simplex virus and the common cold has stemmed from these findings; however, there remains much to be learned regarding the antiviral mechanisms and clinical benefit of zinc supplementation as a preventative and therapeutic treatment for viral infections.
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Affiliation(s)
- Scott A Read
- Blacktown Medical School, Western Sydney University, Blacktown, New South Wales, Australia
- Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Westmead, New South Wales, Australia
| | - Stephanie Obeid
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Chantelle Ahlenstiel
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Golo Ahlenstiel
- Blacktown Medical School, Western Sydney University, Blacktown, New South Wales, Australia
- Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Westmead, New South Wales, Australia
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