Study of efficacy intralesional injection tuberculin antigen in the treatment of multiple common warts. A randomized, double-blind, placebo-controlled clinical trial. Patients and researchers were blinded.
Inclusion criteria: Patients with multiple common warts with past history of BCG vaccination or positive tuberculin test PPD greater than 5 millimeter or obviously scar in the upper left arm, Multiple warts equally or more than three wart. Exclusion criteria: Pregnancy or lactation, Immunosuppressive patients, Past history of TB disease, Sever reaction such as anaphylaxis to tuberculin antigen, Any generalized dermatitis, receiving other treatments for wart, receiving first and second generation anti TB drugs.
The study was carried out in dermatologic outpatient clinic, Ahvaz University Hospital, after obtaining the informed consent from all patients and parents of children. Our study included 54 patients with multiple common warts. Patient was classified into 2 groups: First group included 27 patients treated with IL (intra wart) tuberculin antigen with a dose of 0.1 ml by insulin syringe. Second group included 27 patients treated with IL saline with a dose of 0.1 ml. In both groups, injections were made into the largest one of the multiple common warts. Injections were repeated for all patients every one week for a total of six injections or less in cases of resolution of warts. At the first visit, the duration, location, number, diameter of all warts were reported. Response of distant, anatomically distinct, untreated warts was also noted. Response to treatment was evaluated by the decrease in size of warts and by photographic comparison. The response was considered complete if there was disappearance of 75-100% warts and return of normal skin marking , partial if the warts had regressed in size and number by 50-74% , minimal response if the was regressed in size and number by 25-49% and no response if the warts had regressed in size and number by leaser than 25%. Immediate and late adverse effects of tuberculin antigen were evaluated after each treatment session. After the sixth injection, if wart was not completely healed, the patient refer for cryotherapy. Follow up was made every two months for six months to detect any recurrence.