Intralesional acyclovir versus cryotherapy in treatment of plantar warts: A randomized controlled trial

Abstract

Background: Plantar warts are known for their recalcitrant nature. Intralesional acyclovir injection has been recently tried for treatment of warts.

Objective: Comparing the efficacy and safety of intralesional acyclovir versus cryotherapy in treatment of plantar warts.

Methods: Sixty-eight patients with plantar warts were randomized into: one group (34 patients with a total of 51 warts) received intralesional acyclovir, and the other group (34 patients with a total of 72 warts) underwent cryotherapy. Patients in both groups received a maximum of 5 sessions with 2-week intervals.

Results: Complete cure of plantar warts was observed in 68.6% in the intralesional acyclovir group versus 61.1% in the cryotherapy group (P = .393). A significantly higher number of sessions was needed to achieve complete cure in the intralesional acyclovir group (3.8 versus 3 sessions, P = .001). The procedure was significantly more painful in the intralesional acyclovir group with an average visual analog scale score of 6.5 versus 4.65, P = .005).

Limitations: Blinding was not feasible in this study because of the distinctly 2 different techniques of treatment modalities used.

Conclusion: Intralesional acyclovir is a promising therapeutic modality for plantar warts, demonstrating similar efficacy to cryotherapy, but the procedure is significantly more painful.

Keywords: acyclovir; cryotherapy; plantar wart.