Abstract Background: Intralesional Vitamin D3 has recently demonstrated encouraging outcomes in the treatment of various wart types. Purpose: This study evaluated the efficacy and safety of intralesional Vitamin D3 in the treatment of viral warts. Methods: We included randomized controlled trials that reported the efficacy of intralesional Vitamin D3 in the treatment of warts. Results: Twenty-eight studies with a total of 1983 patients were included. For all types of warts, intralesional Vitamin D3 was more effective than placebo (risk ratio RR = 6.44; 95% confidence interval CI: 2.58–16.10, P < 0.0001), Candida antigen (Ag) (RR = 1.14; 95% CI: 0.76–1.71, P = 0.54), and cryotherapy (RR = 1.52; 95% CI: 1.18–1.95, P = 0.01) in achieving complete clearance of warts at site of injection. Vitamin D3 was less effective than purified protein derivative (PPD) (RR = 0.90; 95% CI: 0.76–1.05, P = 0.18), measles, mumps, and rubella (MMR) (RR = 0.89; 95% CI: 0.76–1.05, P = 0.18), and Bacillus Calmette–Guérin (BCG) (RR = 0.69; 95% CI: 0.53–0.90, P = 0.005). In patients with plantar warts, intralesional Vitamin D3 was more effective than Candida Ag (RR = 1.44; 95% CI: 0.87–2.36, P = 0.15), zinc sulfate 2% (RR = 1.20; 95% CI: 0.81–1.77, P = 0.36), and placebo (RR = 4.87; 95% CI: 1.43–16.63, P = 0.01). For common warts, Vitamin D3 was more effective than placebo (RR = 8.25; 95% CI: 1.65–41.29, P = 0.01). Vitamin D3 also cleared more distant warts than did placebo (RR = 11.83; 95% CI: 3.39–41.26, P = 0.0001) and zinc sulfate 2% (RR = 2.50; 95% CI: 0.06–105.62, P = 0.63). Efficacy of Vitamin D3 in achieving complete cure at distant sites was lower than for Candida Ag (RR = 0.56; 95% CI: 0.20–1.57, P = 0.27) and PPD (RR = 0.93; 95% CI: 0.69–1.25, P = 0.63). Most of the adverse effects associated with Vitamin D3 were not severe. Vitamin D3 had lower recurrences than Candida Ag, MMR, zinc sulfate 2%, and placebo, while PPD showed better results than Vitamin D3. Conclusion: Intralesional Vitamin D3 is an effective and tolerable immunotherapeutic agent for wart treatment.
El-Ebiary et al. (Tue,) studied this question.