Abstract
Intralesional Injections of Vitamin D3 Versus 2% Zinc Sulfate for the Treatment of Palmoplantar Warts: A Comparison of Efficacy and Safety
Abrar ul Haq1, Hira Tariq2, Rameen Masood1, Sehrish Ashraf3, Uzma Amin4, Faria Asad5, Saelah Batool6
Keywords: Safety, intralesional injection, palmoplantar, vitamin D3, warts, zinc sulfate
DOI: 10.63475/yjm.v5i1.0279
DOI URL: https://doi.org/10.63475/yjm.v5i1.0279
Publish Date: 05-04-2026
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Author Affiliation:
1 MBBS, Postgraduate Resident, Department of Dermatology, Services Hospital, Lahore, Pakistan
2 MBBS, FCPS Dermatology, Assistant Professor, Department of Dermatology, Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan
3 MBBS, FCPS Dermatology, Consultant, Department of Dermatology, Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan
4 MBBS, FCPS Dermatology, Senior Registrar, Department of Dermatology, Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan
5 MBBS, FCPS Dermatology, Professor, Department of Dermatology, Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan
6 MBBS, FCPS Dermatology, Associate Professor, Department of Dermatology, Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan
Abstract
Background: Warts are benign epithelial tumors due to several human papillomavirus strains affecting people of all age groups. Warts give an unappealing look and mostly remain asymptomatic. However, they can become painful, as is the case with palmoplantar warts. For warts, different treatment approaches are available, but all the treatments are very expensive, time-consuming, and painful, and recurrence is very common. This study aimed to compare the efficacy and safety of intralesional injections of vitamin D3 and 2% zinc sulphate solution in the treatment of palmoplantar warts.
Methods: In this prospective comparative interventional study (non-randomized trial), done from January 2023 to July 2023, patients with warts from the Outpatient Department of Dermatology of Services Hospital, Lahore, were included. Patients were alternately divided into two groups. Group A patients were given intralesional vitamin D3, while Group B patients were injected with a 2% zinc sulfate solution. Follow-up was done fortnightly for 8 weeks, and then after 12 weeks. Complete response was considered when there was a complete resolution of warts, partial response; if there was >50% and less than 100% reduction in the original width of warts, poor response; if the reduction in the original width of warts was <50%, and no response if there was no recovery after four treatment sessions. Data was collected through a predesigned proforma and entered and analyzed using SPSS version 27.0. The chi-square test was used to compare the percentage reduction in the two treatment groups, while the Student’s t-test was applied for quantitative variables. P-value <0.05 was considered significant.
Results: The study comprised a total of 90 patients. Both groups comprised 45 patients each, with 100% compliance and similar demographics. Among group A (vitamin D3) patients, 73.3% had a complete response, 11.1% had a partial response, and 6.7% had a poor response, while 8.9% patients had no response after 12 weeks of treatment. Regarding side effects, only 6.7% of patients had scarring at the end of 12 weeks of treatment. Among 45 patients of Group B (2% Zinc Sulfate), 62.2% had a complete response, 20.0% had a partial response, and 6.7% had a poor response, while 11.1% patients had no response after 12 weeks of treatment. Among these patients, 4.4%, 2.2%, and 11.1% at the end of 12 weeks of treatment had erythema, dryness, and scarring, respectively. However, except for the assessment at the end of week 2 (P < 0.001), no statistically significant differences were observed between treatments at 4 weeks (P = 0.067), 6 weeks (P = 0.058), 8 weeks (P = 0.803), and after 12 weeks (P = 0.645) of the treatment period.
Conclusions: Both 2% zinc sulfate solution and vitamin D3 were found to be efficacious and safe in the treatment of palmoplantar warts without a statistically significant difference. Therefore, both treatment modalities can be utilized in patients with palmoplantar warts.