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Oral vs Topical Isotretinoin in the Treatment of Plane Warts
Plane warts are a common therapeutic problem. A study published in the International Journal of Dermatology sought to assess the efficacy and safety of oral versus topical isotretinoin in the treatment of plane warts.
Forty patients with multiple plane warts were randomised into two groups. Group A was treated with oral isotretinoin capsules in the dose of 0.5 mg/kg/d and Group B with topical isotretinoin 0.05 per cent in gel formulation once daily at night.
Treatment was given to the patients for three months or until the complete clearance of lesions, whichever was earlier. Patients with complete response were followed up monthly for four months to record the relapse rate.
Results were analysed in 16 patients of Group A and 13 patients of Group B. At the end of three months of therapy, 11 (69 per cent) patients in Group A had complete remission while five (31 per cent) had partial remission.
In Group B, at the end of study, five (38 per cent) patients had complete remission and six (46 per cent) had partial remission, while two patients had no remission.
The difference was statistically significant between two groups; P < 0.0001. The most common side effect in Group A was cheilitis. In Group B, five patients had to be excluded because they developed severe erythema and scaling.
The study concluded that oral isotretinoin showed better and earlier response than topical isotretinoin. It recommended that oral isotretinoin should definitely be given a trial particularly in cases of multiple facial warts before trying various destructive procedures.
Kaur, G. J., Brar, B. K., Kumar, S. , Brar, S. K. and Singh, B. (2017), Evaluation of the efficacy and safety of oral isotretinoin versus topical isotretinoin in the treatment of plane warts: a randomized open trial. Int J Dermatol, 56: 1352-1358. doi:10.1111/ijd.13727
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