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REVIEW

Efficacy and Safety Profile of Tuberculin Protein Purified Derivative Injection As Immunotherapy For the Treatment of Cutaneous and Anogenital Warts: A Review Article

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Pages 123-150 | Received 28 Oct 2023, Accepted 22 Feb 2024, Published online: 04 Mar 2024

References

  • Fields JR, Saikaly SK, Schoch JJ. Intralesional immunotherapy for pediatric warts: a review. Pediatr Dermatol. 2020;37(2):265–271. doi:10.1111/pde.14094
  • Aldahan AS, Mlacker S, Shah VV, Kamath P, Alsaidan M, Samarkandy S. Efficacy of intralesional immunotherapy for treating warts: a review of the literature. Dermatol Ther. 2016;29(3):197–207. doi:10.1111/dth.12352
  • Ju HJ, Park HR, Kim JY, Kim GM, Bae JM, Lee JH. Intralesional immunotherapy for non-genital warts: a systematic review and meta-analysis. Indian J Dermatol Venereol Leprol. 2022;88(6):724–737. doi:10.25259/IJDVL_1369_20
  • Diab N, Atef H, Salah E. Intralesional injection of purified protein derivative in the treatment of viral warts: a pilot study. Egypt J Hosp Med. 2021;85(1):3198–3201. doi:10.21608/ejhm.2021.195432
  • Gilson R, Nugent D, Werner RN, Ballesteros J, Ross J. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2020;34(8):1644–1653. doi:10.1111/jdv.16522
  • Kanchana L, Thammarucha S, Suchinwanitnit P, Rutnin S. A comprehensive review of treatment options for recalcitrant nongenital cutaneous warts. J Dermatol Treat. 2022;33(1):23–40. doi:10.1080/09546634.2020.1737635
  • Sindhuja T, Bhari N, Gupta S. Asian guidelines for condyloma acuminatum. J Infect Chemother. 2022;28(7):845–852. doi:10.1016/j.jiac.2022.03.004
  • Mohta A, Sharma MK, Kumari P, Ghiya BC, Mehta RD. An intention-to-treat-analysis of the efficacy of immunotherapy using Mycobacterium w vaccine and purified protein derivative of tuberculin for warts with assessment of improvement in quality of life. Dermatol Pract Con. 2022;12(2):1–7.
  • Obbus SFV, Barit JJG, Yap-silva C. Efficacy of intralesional purified protein derivative for cutaneous warts: a meta-analysis. Acta Med Philipp. 2019;53(4):360–368. doi:10.47895/amp.v53i4.37
  • Yang H, Kruh-Garcia N, Dobos K. Purified protein derivatives of tuberculin - past, present, and future. FEMS Immunol Med Microbiol. 2012;66(3):273–280. doi:10.1111/j.1574-695X.2012.01002.x
  • Amirnia M, Khodaeiani E, Fouladi DF, Masoudnia S. Intralesional immunotherapy with tuberculin purified protein derivative (PPD) in recalcitrant wart: a randomized, placebo-controlled, double-blind clinical trial including an extra group of candidates for cryotherapy. J DermatolTreat. 2016;27(2):173–178. doi:10.3109/09546634.2015.1078871
  • Choudhary D, Piya S. Treatment of warts by immunotherapy using purified protein derivative. Birat J Heal Sci. 2018;3(2):463–467. doi:10.3126/bjhs.v3i2.20961
  • Kus S, Ergun T, Gun D, Akin O. Intralesional tuberculin for treatment of refractory warts. J Eur Acad Dermatol Venereol. 2005;19(4):515–516. doi:10.1111/j.1468-3083.2004.01176.x
  • Mishra A, Shrestha S, K.c. S, Karn D. A prospective clinical study for safety and efficacy of intralesional tuberculin purified protein derivative in treatment of palmoplantar verruca. J Nobel Med Coll. 2022;11(1):12–16. doi:10.3126/jonmc.v11i1.45720
  • Azab M, El-shabrawy MM, Nafea ER, Nada HA. Measurement of serum interleukin 17 level in patients with genital warts before and after intralesional tuberculin injection. J Men’s Health. 2021;18(1):1.
  • Abd-Elazeim FMA, Mohammed GFA, Fathy A, Mohamed RW. Evaluation of IL-12 serum level in patients with recalcitrant multiple common warts, treated by intralesional tuberculin antigen. J DermatolTreat. 2014;25(3):264–267. doi:10.3109/09546634.2013.768760
  • Shaheen MA, Salem SAM, Fouad DA, El-Fatah AAA. Intralesional tuberculin (PPD) versus measles, mumps, rubella (MMR) vaccine in treatment of multiple warts: a comparative clinical and immunological study. Dermatol Ther. 2015;28(4):194–200. doi:10.1111/dth.12230
  • Abou-Taleb DAE, Abou-Taleb HA, El-Badawy O, Ahmed AO, Hassan AET, Awad SM. Intralesional vitamin D3 versus intralesional purified protein derivative in treatment of multiple warts: a comparative clinical and immunological study. Dermatol Ther. 2019;32(5):1–6. doi:10.1111/dth.13034
  • Sil A, Dasgupta S, Chandra S, Datta A, Banerjee A, Das NK. Changes in cytokine profile with immunotherapy in viral warts using purified protein derivative, mumps measles rubella vaccine, and Mycobacterium w vaccine. Indian J Dermatol. 2021;66(1):67–73. doi:10.4103/ijd.IJD_206_20
  • Johnson S, Roberson P, Horn T. Intralesional injection of mumps or Candida skin test antigens: a novel immunotherapy for warts. Arch Dermatol. 2001;137(4):451–455.
  • Ahmed R, Bhadbhade SP, Noojibail B, Shetty SM, Varghese A. Comparative study in efficacy and safety of intralesional injections of vitamin D3, measles rubella (MR) vaccine, and purified protein derivative (PPD) in the management of cutaneous warts. J Cutan Aesthet Surg. 2020;13(4):326–332. doi:10.4103/JCAS.JCAS_39_20
  • Alajlan A. Intra-lesional injection of tuberculin skin test antigens as an immunotherapy for warts: open label placebo controlled clinical trial. Medical Science. 2020;24:105.
  • Awad SM, Gomaa AS, Hassan HA, Tawfik YM. Efficacy of cryotherapy combined with intralesional tuberculin purified protein derivative (PPD) versus intralesional tuberculin PPD monotherapy in the treatment of multiple common warts. Dermatol Ther. 2022;35(4):1–14.
  • Awad A, Ismael AF, Sallam M, Abdelgaber S. Intralesional purified protein derivative versus zinc sulfate 2% in the treatment of pediatric warts: clinical and dermoscopic evaluation. J Cosmet Dermatol. 2022;21(10):4637–4645. doi:10.1111/jocd.14876
  • Bhalala K, Poojary S, Shah K. Comparative study of efficacy of intralesional purified protein derivative (PPD) versus intralesional measles, mumps, and rubella (MMR) vaccine in management of multiple viral warts. J Cutan Aesthet Surg. 2021;14(4):397. doi:10.4103/JCAS.JCAS_166_19
  • Bhargava S, Kumar U. Purified protein derivative (PPD) as immunotherapy for warts: how effective is it? Australas J Dermatol. 2019;2019:1.
  • Chandra S, Sil A, Datta A, Pal S, Das NK. A double-blind, randomized controlled trial to compare the effectiveness and safety of purified protein derivative of tuberculin antigen with Mycobacterium w vaccine in the treatment of multiple viral warts. Indian J Dermatol Venereol Leprol. 2019;85:355–366. doi:10.4103/ijdvl.IJDVL_549_18
  • Diab N, Atef H. Comparative efficacy of using a combination of intralesional purified protein derivative with low dose isotretinoin in the treatment of recalcitrant common warts. Dermatologic Therapy. 2022;2022:1–8.
  • Durgadevi S, Shridharan P. Treatment of periungual warts: comparison of topical 5 % 5-fluorouracil and intralesional purified protein derivative in a South Indian teaching hospital. Int J Res Dermatol. 2018;4(4):574–578. doi:10.18203/issn.2455-4529.IntJResDermatol20184464
  • Eassa BI, Abou-Bakr AA, El-Khalawany MA. Intradermal injection of PPD as a novel approach of immunotherapy in anogenital warts in pregnant women. Dermatol Ther. 2011;24(1):137–143. doi:10.1111/j.1529-8019.2010.01388.x
  • Elela IMA, Elshahid AR, Mosbeh A. Intradermal vs intralesional purified protein derivatives in treatment of warts. Golf J Deramatol Venereol. 2011;18(2):21–26.
  • Farhana K, Asia AJ. Comparative study of therapeutic efficacy of intralesional vitamin D3 versus intralesional purified protein derivative in the treatment of warts. Int J Sci Res. 2020;4(3):226–231.
  • Fatima SM, Ejaz A, Anwar A. Comparison of efficacy of intralesional purified protein derivative (PPD) with cryotherapy in the treatment of cutaneous warts. Pakistan Armed Forces Med J. 2019;69(5):965–970.
  • Fawzy MM, Nofal A, Alakad R. Intralesional antigen immunotherapy for the treatment of plane warts: a comparative study. Dermatol Ther. 2020;33(6). doi:10.1111/dth.13807
  • Ghaly NE, El-Ashmawy AA, Abou Zeid M, Shaker ESE. Efficacy and safety of intralesional injection of vitamin D3 versus tuberculin PPD in the treatment of plantar warts: a comparative controlled study. J Cosmet Dermatol. 2021;20(4):1231–1240. doi:10.1111/jocd.13712
  • Ibrahim H, El Taieb M, Nada E, Kamal E. Combined intralesional injection of tuberculin purified protein derivative plus cryotherapy versus each alone in the treatment of multiple common warts. Dermatologic Therapy. 2022;2022:1–6.
  • Jain S, Marfatia YS. A comparative study of intralesional vitamin D3, measles mumps rubella vaccine, and tuberculin purified protein derivative in the treatment of recalcitrant warts: an approach to solve a therapeutic conundrum. J Clin Aesthet Dermatol. 2021;14(11):26–34.
  • Jaiswal A, Gupta K, Sharma RP, Bedi G. Immunotherapy with PPD in treatment of warts: an open labelled study from western Uttar Pradesh. Indian J Clin Exp Dermatol. 2019;5(1):41–45. doi:10.18231/2581-4729.2019.0010
  • Kaimal S, Gopinath H, Premalatha V. Intralesional immunotherapy with purified protein derivative (PPD) for cryotherapy-resistant warts. Int J Dermatol. 2020;59(6):726–729. doi:10.1111/ijd.14839
  • Milante RR, Venida-Tablizo A, King-Ismael D. Efficacy and safety of single versus multiple intralesional immunotherapy with purified protein derivative (PPD) in the treatment of multiple verruca vulgaris. Int J Dermatol. 2019;58(12):1477–1482. doi:10.1111/ijd.14652
  • Mohammed YF, Ibrahim HS, Elbarbary MA, Elsaie ML. Comparative study of intralesional tuberculin protein purified derivative (PPD) and intralesional measles, mumps, rubella (MMR) vaccine for multiple resistant warts. J Cosmet Dermatol. 2020;2020:1–7.
  • Mohta A, Jain SK, Mehta RD, Arora A. Intralesional purified protein derivative of tuberculin versus intralesional Mycobacterium w vaccine in treatment of recalcitrant extragenital warts: a randomized, single-blinded, comparative study. Indian J Dermatol. 2018;63(2):125–130. doi:10.4103/ijd.IJD_585_17
  • Moubasher AA, Kolta M, Gaber H. Tuberculin purified protein derivative and cryotherapy in the treatment of genital warts: a randomized controlled trial. Hum Androl. 2021;11(11):1–6. doi:10.21608/ha.2021.61492.1075
  • Nada HA, El-Shabrawy MM, Ibrahim SH, Azab M. Measurement of serum glutathione peroxidase, catalase and superoxide dismutase concentration in patients with external anogenital warts before and after treatment with intralesional tuberculin purified protein derivative. Andrologia. 2020;52(9):1–6. doi:10.1111/and.13661
  • Nimbalkar A, Pande S, Sharma R, Borkar M. Tuberculin purified protein derivative immunotherapy in the treatment of viral warts. Indian J Drugs Dermatol. 2016;2(1):19. doi:10.4103/2455-3972.184103
  • Nofal A, Yehia E, Khater E, Bessar H. Alternating intralesional purified protein derivative and Candida antigen versus either agent alone in the treatment of multiple common warts. J Am Acad Dermatol. 2020;83(1):208–210. doi:10.1016/j.jaad.2020.01.054
  • Nofal A, Alakad R, Fouda I, Fawzy MM. Intralesional antigen immunotherapy in the treatment of periungual warts. J Cutan Med Surg. 2021;25(3):286–292. doi:10.1177/1203475420988859
  • Nofal AA, Elkholy BM, Abd-Elmonsef ER, Nofal HO. Triple intralesional antigen immunotherapy versus monoantigen in the treatment of multiple recalcitrant warts. Dermatol Ther. 2022;12(5):1225–1237. doi:10.1007/s13555-022-00725-x
  • Podder I, Bhattacharya S, Mishra V, Sarkar TK, Chandra S, Sil A. Immunotherapy in viral warts with intradermal Bacillus Calmette-Guerin vaccine versus intradermal tuberculin purified protein derivative: a double-blind, randomized controlled trial comparing effectiveness and safety in a tertiary care center in Eastern India. Indian J Dermatol Venereol Leprol. 2017;83(3):411. doi:10.4103/0378-6323.193623
  • Pundir M, Singh K, Kanodia S. Efficacy of tuberculin purified protein derivative (PPD) in the treatment of plane warts on face. Medpulse Int Med J. 2018;9(1):71–75. doi:10.26611/10219117
  • Puri N. A study on the efficacy of immunotherapy with purified protein derivative for the treatment of recalcitrant warts. Int J Curr Res. 2019;2019:3–5.
  • Raveendra L, Raju B, Dharam KKC, Mohan V, Yadav K. Comparison of purified protein derivative and vitamin D in the treatment of recalcitrant warts. Clin Dermatology Rev. 2021;5(1):54. doi:10.4103/CDR.CDR_51_20
  • Saoji V, Lade NR, Gadegone R, Bhat A. Immunotherapy using purified protein derivative in the treatment of warts: an open uncontrolled trial. Indian J Dermatol Venereol Leprol. 2016;82(1):42–46. doi:10.4103/0378-6323.171650
  • Sharquie KE, Al-Rawi JR, Noaimi AA, Majly WH. Tuberculin as intralesional therapy for viral warts—single-blind, split, placebo, controlled study. J Cosmet Dermatological Sci Appl. 2016;06(05):191–198.
  • S G, Kumar A. Intralesional immunotherapy with purified protein derivative antigen in the treatment of multiple cutaneous warts: an open label study in an urban teaching hospital. Int J Res Dermatology. 2020;6(6):739. doi:10.18203/issn.2455-4529.IntJResDermatol20204436
  • Tawfik NZ, Eyada MM, El Hamid REA, Halim HM. Intralesional injection of purified protein derivative versus Candida antigen in treatment of genital warts. Dermatol Ther. 2022;35(10):e15762. doi:10.1111/dth.15762
  • Wan Ahmad Kammal W, Jamil A, Md Nor N. Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: an assessor-blinded, randomized controlled trial. Dermatologic Therapy. 2021;2021:10–15.
  • Achdiat PA, Antariksa NC, Rowawi R, Suwarsa O, Hidayat YM, Dwiyana RF. The success of intralesional purified protein derivative immunotherapy in the treatment of anogenital warts: a case report. J Exp Pharmacol. 2022;14:131–135. doi:10.2147/JEP.S347241
  • Alhashmi S, Sadek A. Case report: successful treatment of giant condyloma acuminata with intralesional injection of purified protein derivative. Open Dermatol J. 2021;15(1):36–38. doi:10.2174/1874372202115010036
  • Manoj S, Manjunath P, Mallikarjun M. A study to assess the efficacy of intradermal purified protein derivative (PPD) in treatment of multiple warts. Paper Presented in 24th World Congress of Dermatology, Milan, Italy. 2019. https://www.wcd2019milan-dl.org/abstract-book/documents/late-breaking-abstracts/26-medical-therapies-pharmacology/a-study-to-assess-the-55.pdf. Accessed 29 February, 2024.
  • Nofal A, Fouda I. Switching between intralesional antigens: a promising therapeutic approach for recalcitrant warts. JAAD Case Rep. 2020;6(10):1032–1035. doi:10.1016/j.jdcr.2020.07.045
  • Al Hamzawi NK, Abdallah MH. Managing recalcitrant warts: facts about Bacillus Calmette-Guerin (BCG), Mycobacterium indicus pranii (Mw vaccine), and purified protein derivative (PPD) as immunotherapy. J cosmet dermatol sci appl. 2018;2018:218–235.
  • Aktaş H, Ergin C, Demir B, Ekiz Ö. Intralesional vitamin D injection may be an effective treatment option for warts. J Cutan Med Surg. 2016;20(2):118–122. doi:10.1177/1203475415602841