Of the 201 patients enrolled in the study, 95 received injections of antigen and 106 received injections of either saline or interferon alfa-2b alone. "Fifty-seven subjects injected with antigen were judged to have 100 percent resolution of warts at study conclusion, 21 of whom had more than one wart and experienced 100 percent resolution of all distant warts," the authors report. "In the interferon alfa-2b and saline groups, these numbers were 25 and 11, respectively." The researchers also found that patients who responded to treatment were much more likely to have an immune response to HPV.

"Our repeated observation that untreated warts resolve after injection of only one wart prompts the speculation that intralesional [injection into the wart] immunotherapy induces HPV-directed immunity," the authors write. "Indeed we have observed resolution of hundreds of flat warts in individual patients after injection of only one lesion. It is possible that local and distant responses of warts in subjects who received saline or interferon alfa-2b alone develop by the same mechanism as when antigen is injected and that many triggers of an immune response to HPV exist. While injection of saline is an appropriate control, it is not a true placebo. That noted, local and systemic responses to saline injection in this study were far less likely than when antigen was used."

"Intralesional immunotherapy for common warts is effective and safe," the authors conclude. "It is unique in affording many patients a therapeutic response in untreated warts and may, through stimulation of HPV-directed immunity, provide fewer recurrent warts. While useful in any patient with warts, intralesional immunotherapy may be particularly useful in patients with numerous lesions or lesions covering large surface areas."

(Arch Dermatol. 2005; 141:589-594. Available post-embargo at www.archdermatol.com.)

Editor's Note: This study was su
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Contact: Leslie Taylor
501-686-8998
JAMA and Archives Journals
16-May-2005

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