Authors: Shahara Abalos, MD, Jay-V James G. Barit, MD, Francisca D.C. Roa, MD, FPDS


Introduction: Potassium hydroxide (KOH) is a strong alkali that is effective, safe, and well tolerated in the treatment of different dermatoviruses. No systematic review has been done reporting its efficacy as a treatment for anogenital warts.

Objectives: To determine the efficacy and safety of potassium hydroxide versus placebo, pharmacoactive drug or ablative procedure in achieving clinical clearance of patients diagnosed with condyloma acuminata

Methods: A systematic literature search for controlled clinical trials using KOH, any drug or ablative procedure measuring the clearance rate was conducted. Analysis was done using RevMan v5.3 software.

Results: Four trials composed of 197 patients deemed as low quality trials were included however only two qualified for meta-analysis. Two studies compared 5% KOH to cryotherapy and included in the quantitative analysis meanwhile the others compared it to intralesional 5-fluorouracil (FU) + salicyclic acid (SA) and carbon dioxide (CO2) laser vaporization respectively. The KOH group demonstrated a better clearance rate compared to cryotherapy (RR= 1.40, P> 0.05, I2=39 %) and no recurrence was noted (RR= 0.17, P> 0.05, I2=0) however the difference is not statistically significant. Isik et al. and Asadi showed that there were no significant differences between groups receiving KOH, 5-FU+SA and CO2 laser vaporization respectively in the mean lesion counts and size at any evaluation visit during the study (P > 0.05).

Conclusions: Potassium hydroxide has comparable efficacy to the present treatment modalities and has tolerable local side effects but well-structured randomized controlled trials are needed to further support its use.





potassium hydroxide, anogenital warts, condyloma acuminata

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