Warts are benign tumours caused by human papilloma viruses (HPV) with over 100 genotypes known till now. They are recalcitrant to treatment and prone for recurrences. Majority of the conventional treatment modalities are destructive, painful and have a greater down-time.
Aims: To evaluate the effectiveness and safety of intra-lesional BCG (bacille calmette guerin) immunotherapy in treatment of recalcitrant warts in immunocompetent patients.
Materials and methods: After an informed written consent and routine investigations, 0.1 ml of reconstituted BCG vaccine was injected into the oldest and the largest wart. Patients were evaluated every 2 weeks and were followed up for a period of 6 months. A grading scale was used to assess the response.
Statistical analysis used: The results obtained were statistically analysed and Z test was applied to calculate the significance of the visible difference between palmoplanter warts and common warts.
Results: 46 out of 50 patients completed the study. 80.43% patients (37/46) had multiple warts. 86.66% patients of palmoplanter warts (26/30) showed complete resolution of warts at the end of 6 weeks, 13.33% patients (4/30) showed partial response and none of the patients in this group were non-responders. 60% patients (6/10) of common warts showed complete response and 40% patients (4/10) were non-responders in this group. All the patients (n=4) of periungual warts showed 100% clearance at 3 months. Pain at the injection site (100% ), erythema (78.26% ), fever (76.08% ) and secondary infection (2.17% ) were the main adverse events noted.
Conclusion: BCG immunotherapy is a cheap, safe, effective and easily available therapeutic option which can be easily used in day to day practice.