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A double-blind, randomized controlled trial on the efficacy and safety of intralesional 2% zinc sulfate in the treatment of verruca vulgaris in a tertiary hospital

Abigail T. Siggaoat Arnelfa C. Paliza


Background: Verruca vulgaris ranked 10th in the top 10 diseases in 2019 seen among the Philippine Dermatological Society training institutions. The efficacy of immunotherapy, such as intralesional zinc sulfate (ZS), for warts were reported. Considering the limited studies with promising results on verruca, a study on the efficacy and safety of intralesional zinc in the treatment of verruca was considered.

Objective: This study aims to determine the efficacy and safety of intralesional 2% ZS in comparison to intralesional purified protein derivative (PPD) among adult patients with verruca vulgaris.

Methods: This is a double-blind, randomized, controlled trial involving 44 patients allocated to group ZS (n=22) and PPD (n=22). Intralesional injections of ZS or PPD to the largest wart were done at weeks 0, 2, 4, 6, 8, 10. Clearance and size reduction of the target and distant wart at 12th week and recurrence at 14th week were assessed. Adverse effects were checked.

Results: At the 12th week of treatment, higher proportion in group ZS patients achieved total resolution of the target lesion compared to PPD, but results were not statistically significant (29% vs. 19%). Both groups showed decline in the target lesion size. The median size reduction between the two groups showed no significant differences. Three patients from group ZS showed clearance of distant warts while none in group PPD. There was no recurrence of all previously resolved warts. Adverse reactions were pain, edema, and erythema.

Conclusion: Intralesional 2% zinc sulfate (29%) was efficacious and safe compared to intralesional PPD (19%) but the difference was not statistically significant. There was clearance of distant warts in 5% of group ZS patients. The mild adverse events did not warrant discontinuation of treatment.


Keywords: Carica papaya, pityriasis/tinea versicolor


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A double-blind, randomized controlled trial on the efficacy and safety of intralesional 2% zinc sulfate in the treatment of verruca vulgaris in a tertiary hospital