Systemic treatments for cutaneous warts: A systematic review

Abstract

Background: Systemic therapies are routinely used for the management of cutaneous warts. However, there is a lack of evidence-based data on their effectiveness. Objective: To assess the evidence for the efficacy of systemic treatments for cutaneous warts. Methods: We designed a systematic review of the randomized controlled clinical trials (1962 to April 2010) investigating systemic therapies for the treatment of cutaneous warts. We obtained data from MEDLINE, PubMed, Current Contents, reference lists, and specialist textbooks, with no restriction on language. The main outcome measures were the total clearance of warts and the adverse effects. Results: There was substantial heterogeneity in the design of the trials. No consistent evidence was found for the efficacy of cimetidine, levamisole or homeopathy, and only limited evidence was found for the efficacy of zinc. Conclusions: Reviewed trials of systemic treatments for cutaneous warts were highly variable in methods and quality, and there was a paucity of evidence from randomized, placebo-controlled trials on which to base the rational use of such therapies. Limited evidence is emerging that zinc may be effective in selected populations with zinc deficiency.

Keywords:

• cimetidine
• randomized clinical trial
• wart
• zinc

Declaration of interest : The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.