Evaluation of TNF-α serum level in patients with recalcitrant multiple common warts, treated by lipid garlic extract

Dermatol Ther. 2014 Sep-Oct;27(5):272-7. doi: 10.1111/dth.12136. Epub 2014 Jun 9.


No universal consensus about optimal modality for treating the recalcitrant multiple common warts (RMCW). The objective of the study was to evaluate the immunological mechanisms and clinical therapeutic effect of using lipid garlic extract (LGE) in the treatment of RMCW. The study included 50 patients with RMCW. They were randomly assigned into two groups: the first group (25 patients) received LGE, and the second group (25 patients) received saline as a control group. In both groups, treatments were made to single lesions, or largest wart in case of multiple lesions, until complete clearance of lesions or for a maximum of 4 weeks. Blood serum was taken at pre-study and at the fourth week to measure tumor necrosis factor alpha (TNF-α) level. A significant difference was found between the therapeutic responses of RMCW to LGE antigen and saline control group (p < 0.001). In the LGE group, complete response was achieved in 96% of patients presenting with RMCW. There was a statistically nonsignificant increase in TNF-α of LGE group versus saline group. No recurrence was observed in the LGE group. LGE as an immunotherapy is an inexpensive, effective, and safe modality with good cure rates for treatment of RMCWs, when other topical or physical therapies have failed.

Keywords: lipid garlic extract; recalcitrant multiple common warts; serum TNF-α.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Child
  • Dermatologic Agents / chemistry
  • Dermatologic Agents / isolation & purification
  • Dermatologic Agents / therapeutic use*
  • Double-Blind Method
  • Egypt
  • Female
  • Garlic* / chemistry
  • Humans
  • Immunologic Factors / chemistry
  • Immunologic Factors / isolation & purification
  • Immunologic Factors / therapeutic use*
  • Lipids / chemistry*
  • Male
  • Middle Aged
  • Phytotherapy
  • Plant Extracts / chemistry
  • Plant Extracts / isolation & purification
  • Plant Extracts / therapeutic use*
  • Plants, Medicinal
  • Remission Induction
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood*
  • Warts / blood
  • Warts / drug therapy*
  • Warts / immunology
  • Young Adult


  • Biomarkers
  • Dermatologic Agents
  • Immunologic Factors
  • Lipids
  • Plant Extracts
  • Tumor Necrosis Factor-alpha