Discussion
wart, TNF-α, verrucas
WART, RECURRENCE, DELAYED-TYPE HYPERSENSITIVITY, DISEASE, WARTS, VERRUCAS
HPV-associated verrucas still pose a therapeutic dilemma because of the possible associated disfigurement, recurrence, or inefficiency of the treatment options available [Immunotherapy for warts seems to alert the immune system about the presence of an antigen that requires an immune reply with a consequent type IV delayed-type hypersensitivity response along with upregulation of IL-1, IL-12, TNF-α, and IFN-γ. This immune response, if elicited, is not specific to the injected antigen, but may also act against wart tissue [Previous studies suggest that intralesional antigen immunotherapy with Our results show a higher clearance rate and a better observers’ scores for improvement in warts treated with the Similar to our findings, Khurshid et al. 2009 reported that The demographic characteristics of recruited patients including age did not affect the therapeutic response with Based on our results, a significant association was observed between wart duration and the therapeutic response in the While our result revealed that there was no significant association between wart duration and therapeutic response with DPCP immunotherapy, conversely another study revealed a significant decrease in success rate as disease duration increased, probably because of its lower capacity to stimulate the immune system in patients with long wart duration [Patients with recalcitrant warts showed a significantly lower median observers’ score for improvement in comparison to those with non-recalcitrant lesions. Contrastingly, Garza et al. 2015 reported that in their cohort with 80.4% patients suffering from recalcitrant warts, complete clearance was achieved with Our results showed that 40% of the Although, to the best of our knowledge, no comparisons between these two modalities could be retrieved, The discrepancy in results among studies, including ours, for both The proper choice of treatment modality for warts has been discussed before [Our findings should always be read with some limitations in mind. We were only able to assemble a small sample size, which might affect statistical evaluation and conclusions, and the follow-up period was limited so we still do not have a full perspective of the persistence of the results.