Intralesional quadrivalent human papillomavirus vaccine in the treatment of recalcitrant genital warts in females of the skin of color: a case series

Genital warts, caused by human papillomavirus (HPV) infection, are among the most commonly transmitted infections worldwide. However, they are often associated with resistance and relapse. Intralesional HPV vaccine is a potential treatment option in such resistant cases, which not only treats warts but also prevents scarring and preserves sexual health. This study evaluated the efficacy and safety of the intralesional HPV vaccine in the treatment of genital warts in eight reproductively active females with a mean age of 33.12±4.07 years. The warts were infiltrated with 0.5 ml quadrivalent HPV vaccine, given at the base of the most prominent wart. The treatment was repeated every 2 weeks for a maximum of three sessions. Four (50%) patients achieved complete wart clearance, three showed partial resolution, and one had no response, which was comparable with previous studies. No significant side effects were observed except for injection site pain, which all patients rated as severe (8–10 on a Likert scale). Posttherapy, no persistent pain was noticed by any patient. One patient with complete clearance had a relapse in warts. This report aims to expand the therapeutic applications of the intralesional HPV vaccine for genital warts. Further large-scale comparative trials are necessary to determine the optimal therapeutic approach accurately.