Comparison of the Efficacy of Intralesional Vitamin D3 and Intralesional 5 Fluorouracil in Treatment of Cutaneous Warts

Background: Cutaneous warts are common benign skin lesions caused by human papillomavirus (HPV) and can be resistant to conventional therapies. Intralesional therapies such as vitamin D3 and 5-fluorouracil (5-FU) have emerged as promising treatment options, yet their comparative efficacy remains under-investigated. Objective: To compare the efficacy of intralesional vitamin D3 and intralesional 5-FU in the treatment of cutaneous warts. Study Design: Randomized controlled trial. Setting: Department of Dermatology, Khyber Teaching Hospital, Peshawar, Pakistan. Duration of Study: 29-September-2024 to 29-March-2025. Methods: A total of 192 patients with clinically diagnosed cutaneous warts were included and randomly assigned into two equal groups. Group A received intralesional vitamin D3 (0.2–0.5 mL of 15 mg/mL) combined with lidocaine-adrenaline, while Group B received intralesional 5-FU (10 units of 250 mg/5 mL) in the same anesthetic solution. Treatment efficacy was defined as >50% reduction in lesion size and number assessed visually. Data were analyzed using appropriate statistical tests, with a p-value <0.05 considered significant. Results: The mean age of participants in Group A was 33.04 ± 11.89 years, while in Group B it was 33.30 ± 11.31 years. The efficacy rate was significantly higher in the 5-FU group (82%) compared to the vitamin D3 group (64%) (p < 0.05). Conclusion: Intralesional 5-FU demonstrated superior efficacy compared to vitamin D3 in the treatment of cutaneous warts, suggesting that 5-FU may be preferred in clinical practice.