Delayed Complete Clearance of Recalcitrant Warts Due to Intralesional Measles, Mumps, and Rubella: Case Report and Review

Warts are a prevalent skin condition that can affect people of any age. They are caused by the human papillomavirus (HPV), a double-stranded DNA virus that can cause benign and malignant lesions and remains latent in the host cells, leading to recurrences. Although warts are benign and spontaneous clearance has been reported over the years, they often cause disfigurement, tend to koebnerize, and can be transmitted to others, making adequate and timely treatment important. Several conventional treatments are available, but none works consistently for all patients. Incomplete responses or recurrences are often bothersome to both patients and dermatologists. Moreover, these treatments are often painful, time-consuming, and can cause significant scarring. Immunotherapy, as an alternative, has found a significant place in the treatment of warts because of its non-destructive action, ease of use, and promising results. This paper will discuss a healthy 36-year-old Bosnian male with chronic palmoplantar and periungual warts. Despite undergoing multiple destructive and topical treatments, including electrocautery, cryotherapy, carbon dioxide laser, salicylic acid, glycolic acid, 5-fluorouracil, and imiquimod, he could not achieve significant improvement in his skin condition. Subsequent treatment with the intralesional measles, mumps, rubella (MMR) vaccine also showed little improvement during treatment. However, three months without further treatment, the patient reported complete resolution of the warts. Follow-up confirmed the clearance with no recurrence and minor post-inflammatory hypopigmentation. Our patient's delayed response to the MMR vaccine aligns with findings from other studies indicating that the body's immune response may take time to manifest fully.