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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mardi 5 novembre 2019
Doi : 10.1016/j.jaad.2019.07.070
accepted : 23 July 2019
Intralesional versus intramuscular bivalent human papillomavirus vaccine in the treatment of recalcitrant common warts

Ahmad Nofal, MD a, , Ayman Marei, MD, PhD b, Al-shimaa M. Ibrahim, MD a, Eman Nofal, MD a, Manal Nabil, MSc a
a Dermatology Department, Zagazig University, Zagazig, Egypt 
b Microbiology and Immunology Department, Zagazig University, Zagazig, Egypt 

Correspondence to: Ahmad Nofal, MD, Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.Dermatology DepartmentFaculty of MedicineZagazig UniversityZagazigEgypt

Despite the availability of different therapeutic modalities, treatment of recalcitrant common warts is still challenging. Cervarix (GlaxoSmithKline, Brentford, UK), a recombinant bivalent human papillomavirus (HPV) vaccine, has shown promising efficacy in the treatment of warts.


To evaluate the beneficial effects and tolerability of intramuscular versus intralesional bivalent HPV vaccine in the treatment of recalcitrant common warts.


The study included 44 adult patients with multiple recalcitrant common warts; 22 patients received intramuscular injection of bivalent HPV vaccine at 0, 1, and 6 months or until complete clearance of warts, and the other 22 patients received intralesional injection of 0.1 to 0.3 mL of bivalent HPV vaccine into the largest wart at 2-week intervals until complete clearance or for a maximum of 6 sessions.


Complete clearance of warts was observed in 18 patients (81.8%) of the intralesional group and 14 patients (63.3%) of the intramuscular group; however, the difference was not statistically significant. Adverse effects were transient and insignificant, and no recurrence was reported in either group.


Small study sample and different dosing schedules.


Bivalent HPV vaccine, particularly by intralesional injection, seems to be a potential therapeutic option for the treatment of multiple recalcitrant common warts.

The full text of this article is available in PDF format.

Key words : bivalent HPV vaccine, HPV vaccines, recalcitrant warts

Abbreviation used : IL

 Funding sources: None.
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.

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