Treatment of Facial Plane Warts, a Comparative Study of Topical 5% KOH Solution with Topical 0.05% Tretinoin Cream.


Abstract Background: Plane warts represent a common self-limiting viral infection of the skin, caused by HPVs with no uniformly effective treatment modality and with a high rate of spontaneous recovery. Aim of the study: To evaluate and compare the effectiveness and safety of topical 5% KOH solution with topical 0.05% Tretinoin cream for the treatment of plane warts. Patients and methods: This study was conducted at Department of Dermatology and Venereology of Baghdad Teaching Hospital / Medical City from April 2015 to July 2016. Sixty six patients enrolled in the study. Patients were divided into two age and sex matched groups; patients in group (A) were treated with topical 5% KOH solution once at night for a maximum period of four weeks while, patients in group (B) were treated with topical 0.05% Tretinoin cream once at night for a maximum period of eight weeks. The patients were evaluated at 2nd, 4th and 8thweeks to assess the cure rates and side effects. Those patients who showed complete cure were asked to stop the treatment and followed up for 3 months to detect any recurrence. Results: Thirty patients from group (A) and twenty eight patients from group (B) completed the study, while the remainders were defaulted for unknown reasons. At the end of the 2nd week; 26.7% of patients in group (A) showed complete disappearance of their warts while, 65.7% of them showed partial response. Regarding group (B); no patients showed complete response, while 75% of the patients showed partial response. At the end of 4th week, 70% of group (A) patients showed complete response in comparison to 28.6% of group (B) patients. Partial or non- responders in group (B) continued with the treatment and were re- assessed at the end of 8th week; (60.7%) of patients had complete response. Recurrence of warts was recorded in 19% of group (A) versus 17.3% in group (B) patients during the 3 months period of follow up. Conclusion: Both 5% KOH solution and 0.05% Tretinoin cream are effective topical therapies in the treatment of plane warts and both can be prescribed as home remedies. The 5% KOH solution is much cheaper with faster action but with more side effects.