Intralesional measles, mumps, and rubella vaccine <i>versus</i> vitamin D for treatment of warts: A randomised clinical trial

Background Warts are prevalent distressing skin growths caused by the human papillomavirus (HPV). These growths are commonly addressed using methods that destroy the tissue, including chemical cautery, electrocautery, or cryotherapy. These methods have many side effects in contrast to intralesional immunotherapy. Objectives This study was conducted to assess the effectiveness, safety, and tolerability of utilising the intralesional measles, mumps, and rubella (MMR) vaccine compared to vitamin D in warts treatment. Methods This randomised clinical trial enrolled 112 participants presenting with multiple warts. The participants were sub-divided into two groups through a random allocation process. Group Ⅰ (n=56) was administered 0.3 mL intralesional MMR vaccine, whereas group Ⅱ (n=56) was administered 0.3 mL intralesional vitamin D3 (equivalent to 15000 IU cholecalciferol). The injection was administered every two weeks into the most noticeable wart, requiring no more than five sessions until improvement. A follow-up period of six months was conducted after the final treatment session. Results A significantly higher percentage of complete response was noticed in the MMR group (80.4%) as compared with the vitamin D group (66.1%). Both groups had an average of four sessions, showing no significant difference. Regarding adverse effects, the MMR group demonstrated a significantly greater incidence of mild pain (96.4%) and injection site itching (12.5%) compared with the vitamin D group. After 6 months of follow-up, no significant difference was noticed in recurrence rates in both groups (3 cases; 5.4% in the vitamin D vs. 2 cases; 3.6% in the MMR group). Conclusion Intralesional MMR demonstrates greater efficacy than vitamin D in treating warts but with a higher incidence of tolerable side effects.