Evaluation of Intralesional Zinc Sulfate Injection in the Treatment of Common Warts

Abstract

SUMMARY W arts are benign proliferations of skin and mucosa that result from infection with human papilloma viruses (HPVs); small double-stranded DNA viruses of the papovavirus class. Over 100 HPV genotypes are identified, with affinity for different sites of the body. The clinical appearance of warts is variable and depends to some extent on the type of HPV involved and the site of infection. There are various types of viral warts including common warts, plantar warts, plane warts, filiform warts, periungual warts, epidermodysplasia verruciformis, oral warts and genital warts. Usually diagnosis is made by clinical examination of the lesions and no laboratory investigations are required. Multiple treatment modalities are available for treating different types of warts but there is no treatment which is 100% effective in completely clearing warts and preventing recurrence in all patients. The ideal aims of the treatment of warts should be to remove the wart without recurrence, avoid aggressive (potentially scaring) procedures, and to assist the immune system in dealing more effectively with the virus and inducing life-long immunity to HPV. Zinc is a main trace element and important nutrient, which exists in all tissues and fluids of the body. At the cellular level, zinc acts as vital component of both enzymes and cofactors. Zinc has diverse biological effects as anti-inflammatory, anti-oxidant, cytotoxic, and healing agent. In addition it has been used as an immunomodulator to treat a viral infection by having an effect on the synthesis of cytokines. In this study, we inject zinc sulphate intralesionally as an immunotherapeutic modality. Our study included: Group 1 (Treatment group) who were treated with zinc sulphate injections. The lesions were in turn subdivided into 3 subgroups; Subgroup (1A): where 50 lesions were injected with 0.5% ZnSO4, Subgroup (1B): where 50 lesions were injected with 2% ZnSO4 and Subgroup (1C): where 50 lesions were injected with 4% ZnSO4.Group 2 (control group) who were treated with either saline or lignocaine injection. The Lesions were in turn subdivided into 2 subgroups; Subgroup (2A): where 50 lesions would be injected with Saline. Subgroup (2B): where 50 lesions would be injected with lignocaine. The results obtained in the present study revealed significantly results in patients with common warts when compared with controls, and it was significantly higher when treating with higher concentration of zinc sulfate. Response to treatment was inversely correlated with age of patients and disease duration. Further studies are recommended to evaluate the efficacy of intralesional injection of zinc sulfate in treating common warts.