Pre-treatment vitamin B12, folate, ferritin, and vitamin D serum levels in patients with warts: a retrospective study

Association of vitamin D with risk of warts: A retrospective and Mendelian randomization study

BACKGROUND

The clinical strategy of oral supplementation of Vitamin D (VD) as a preventive and therapeutic measure for warts needs further exploration.

METHODS

The clinical data of patients with skin diseases who visited the Children's Hospital affiliated with Chongqing Medical University from February 2018 to June 2024 were collected. The serum VD levels in patients with warts (common warts, flat warts, and plantar warts) and patients with other common skin diseases (atopic dermatitis, psoriasis, alopecia areata, vitiligo, and chronic urticaria) were compared. Two-sample bidirectional Mendelian randomization (MR) analysis was performed to investigate potential causal associations between VD and warts.

RESULTS

The average serum VD level of children with warts was 23.27 ± 7.07 ng/mL, which showed no statistically significant difference compared to children with other common skin diseases. The inverse variance weighted (IVW) method analysis indicated a positive causal relationship between VD and warts (Odds Ratio [OR] = 1.86, [95% CI: 1.19-2.92], p = 0.007). Sensitivity analysis did not show any indication of horizontal pleiotropy or heterogeneity. The MR-PRESSO method did not identify any outliers.

CONCLUSION

The levels of serum VD in children with warts do not significantly decrease compared to children with other common skin conditions. The evidence from the MR analysis indicates a positive causal relationship between VD and warts, suggesting caution in supplementing VD for children with warts who have normal or elevated serum VD levels. Further clinical studies are needed for validation in the future.

Topical Calcipotriol for the Treatment of Cutaneous Warts: An Assessor-Blind Randomized Placebo-Controlled Trial

Background. Cutaneous warts are common epidermal proliferations caused by human papillomavirus (HPV). We aimed to determine the safety and efficacy of topical calcipotriol for the treatment of cutaneous warts. Methods. This assessor-blind randomized placebo-controlled trial included 56 patients with cutaneous warts referred to a dermatology clinic from January 21 to March 20, 2020. Patients were randomized into two groups (n = 28). One group received calcipotriol 0.05% ointment twice a day on the lesions with a uniform thickness of 1 mm, and the other group received a placebo. The duration of treatment was twomonths, which continued for another two months if resolution did not occur. The primary outcome was complete response to treatment evaluated four months after the initiation of therapy. Secondary outcomes were the number and size of warts assessed at 1, 2, and 4 months and adverse events, including erythema, pruritus, burning sensation, and scaling. Results. Patients in both groups were comparable regarding previous treatment, underlying disease, and disease duration. However, patients in the control group were older. Also, a higher proportion of patients in the calcipotriol group were male and had warts on their palms and toes. Moreover, a higher percentage of controls had moderate disease. The mean number and the size of lesions did not differ between groups before intervention; however, both were significantly lower in the calcipotriol group than in controls at 1st, 2nd, and 4th months. In addition, complete response to treatment was significantly higher in the calcipotriol group (85.7% vs. 16%; $P<0.001$ ). On the other hand, the frequency of adverse events was not different between groups ( $P=0.352$ ). Conclusions. Calcipotriol can be considered a safe and effective treatment option for cutaneous warts. Trial Registration: This trial is registered with IRCT20170818035762N2, available at https://www.irct.ir/trial/45716.

Clinical use of zinc in viral warts: a systematic review of the clinical trials

BACKGROUND

Zinc has shown promise in the treatment of patients with viral warts in a number of clinical trials, but there is no consensus on its effectiveness.

OBJECTIVE

To investigate the efficacy of various formulations of zinc on cutaneous warts.

DATA SOURCES

We searched the Cochrane Central Register of Controlled Trials, EMBASE, PUBMED and Web of Science without publishing-time restriction. Trials examining zinc in the treatment of warts were collected.

RESULTS

Out of 265 articles, a total of 16 met inclusion criteria. 6 clinical trials investigated clinical effectiveness of oral zinc supplementation alone in treating viral warts, 2 trials evaluated the efficacy of oral zinc in combination with other therapy, 5 trials investigated the efficacy of intralesional zinc sulphate, and 3 trials investigated topical zinc treatment efficacy. Zinc therapy was found to be beneficial in 13 of 16 studies evaluating its effects on warts.

CONCLUSIONS

The use of zinc is a simple, safe and cost-effective treatment in viral warts based on some preliminary evidence. However, more well-designed studies need to be performed to further evaluate the effect of zinc for warts.

Diagnostic and therapeutic implications of vitamin D deficiency in patients with warts: A case-controlled study

BACKGROUND

Cutaneous warts are frequent conditions that possess much challenge to treat.

OBJECTIVE

To verify the potential role of vitamin D in the pathogenesis of viral warts by measuring the serum levels of vitamin D in patients diagnosed with viral warts compared to healthy controls and to verify whether oral vitamin D supplementation of those vitamin D-deficient patients would result in wart clearance.

METHODS

To evaluate the serum vitamin D levels, the study recruited 80 subjects, including 40 patients diagnosed with viral warts and 40 age- and sex-matched healthy controls. All patients were subjected to detailed history taking and examination to detect duration and type of warts. Serum vitamin D levels were measured using ELISA.

RESULTS

Thirty-five percent of patients had sufficient vitamin D levels (54-90 nmol/L), and 40% of patients had insufficient levels (50-80 nmol/L), while 25% of them had deficient levels (<50 nmol/L). In healthy group, 30% had sufficient levels, and 45% had insufficient levels, while 25% had deficient levels. There was an insignificantly lower serum level of vitamin D as well as an insignificantly deficient vitamin D status among patients compared to healthy controls.

CONCLUSION

Vitamin D serum levels appear to be lower among viral wart patients, and oral supplementation studies need to be more intensely investigated before elucidating its role; if any, in wart clearance.