Intralesional ionic contra virus therapy versus 5-fluorouracil in treatment of plantar warts: clinical and dermoscopic evaluation

Background Plantar warts represent a therapeutic challenge for dermatologists. Aim and objectives To evaluate the effectiveness of intralesional injection of ionic contra virus therapy (ICVT) (combined digoxin and furosemide) versus intralesional 5-Fluorouracil (5-FU) in the treatment of plantar warts. Patients and methods This study involved 50 patients with plantar warts divided into two equal groups, group I (25 patients) treated with intralesional ICVT (combined digoxin and Lasix) and group II (25 patients) treated with intralesional 5-FU. The injection was repeated every 2 weeks to a maximum of six sessions (baseline, 2, 4, 6, 8, and 10 weeks). Dermoscopic examination to all patients was done to confirm the diagnosis of wart and also to follow-up the response to treatment. Results Complete/partial response was observed at higher rates among patients of group-II (96%) compared with group-I (72%). No response was higher among group-I (28%) than group-II (4%). Regarding a number of sessions, group II patients had significantly ( P <0.001) lower mean number of sessions (3.5±1.9) than group I (5.98±0.4). Respecting the side effects of treatment, a significant difference ( P <0.001) in the rate of side effects between the two treatment modalities was recorded. The majority (92%) of group-II patients had pain for 12 h after injection, and only one (4%) case had small ulcer while all cases of group-I had no side effects. Conclusion Both intralesional ICVT and 5-FU were effective, safe, and well-tolerated methods for the treatment of plantar warts clinically and dermoscopically, however, intralesional 5-FU had relatively higher efficacy.