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2009, Number 1

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Rev Cent Dermatol Pascua 2009; 18 (1)

Impact of adherence on the effectiveness of intralesional candidin vs. topical salicylic acid at 27% in the treatment of common warts

Lizárraga GC, Rodríguez AM

Language: Spanish
References: 81
Page: 5-18
PDF size: 339.04 Kb.


ABSTRACT

Background: There are too many treatments for viral warts, from home medicines to invasive methods, but none has proved to be entirely effective, particularly in recalcitrant lesions. Among the current therapeutic options with better prospects, it has been mentioned the use of drugs that act by modifying the immune response, such as intralesional antigens. Another important fact is the possible effect that adherence to treatment may have on its effectiveness in order to achieve better clinical outcomes. Objective: To compare and determine the influence of adherence to treatment in the effectiveness of intralesional candidin against topical salicylic acid at 27% in the treatment of common warts. Materials and methods: We conducted a randomized controlled clinical trial, which included two groups of 33 patients each, aging from 6 to 18 years old with common warts. Patients in Group A were applied topical 27% salicylic acid daily on every lesion, while in Group B, intralesional candidin was administered in the longest evolution-time wart, at monthly doses and during 3 months. Adherence to treatment, clinical improvement and adverse effects at the 1st, 2nd, 3rd, 4th and 6th months were assessed. Finally, we calculated the relative risk (RR) between clinical improvement and adherence to treatment. Results: The average improvement achieved in Group A was of 31%, and of 52% in Group B (p ‹ 0.05). Likewise, 7 patients (21%) in Group A against 13 (39%) in Group B, showed a 100% cure. There was a good adherence to treatment in 14 patients (42%) in Group A against 28 patients (84%) in Group B. Pain was the most frequently reported side effect in Group A and erythema in Group B. With regard to the pain associated with the injection of candidin, it was described as mild by 18 patients (55%). The RR was of 0.62. Conclusions: The clinical improvement and the adherence to treatment were higher in Group B. However, both treatments are considered similar in effectiveness because the difference among them was less than the 30%. It was observed a relationship between the adherence to the treatment and its effectiveness of. The adverse effects were well tolerated in both groups. We suggest the use of candidin as a therapeutic option for the treatment of patients with multiple and recalcitrant common warts.


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