Entrar/Registro  
HOME SPANISH
 
Dermatología Revista Mexicana
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Dermatología Revista Mexicana >Year 2011, Issue 1


Cruz PDMC, Padilla DMC, Alonzo-Romero PL, Palma RA, Peralta PML
Candidine treatment in patients with recalcitrant warts
Dermatología Rev Mex 2011; 55 (1)

Language: Español
References: 29
Page: 9-16
PDF: 497.94 Kb.


Full text




ABSTRACT

Background: Viral warts are a common disease in humans. They are considered recalcitrant when do not respond to any therapeutic regimen or relapse quickly. There is no choice treatment but different therapeutic modalities with variable effect. The destructive methods are most used, but in case reports candidin seems to be promising and is proposed as a therapeutic mechanism with immunostimulant effect.
Objective: To determine the efficacy and safety of treatment with intralesional candidin for 12 weeks, compared with saline solution.
Patients and method: In a randomized, double-blind, placebo-controlled sudy patients older than six years (from the outpatient consult of Centro Dermatologico Pascua from November 1, 2008 to March 1, 2009) with a clinical diagnosis of common warts that had not responded to at least two treatments. We excluded patients with diabetes, hypertension, pregnancy, lactation, immunosuppressant, genital warts, generalized dermatitis or a history of allergy to antigenic preparations. The study group was treated with a yeast-derived antigen from Candida albicans (candidin) and the placebo group with 0.9% saline solution, both intralesional, in the oldest or larger wart with a dose of 0.1 cc in three applications, with an interval of four weeks among each.
Results: There were no significant differences between groups with respect to age, duration, size of the lesion, total number of injuries and number of prior treatments. In the study group, the number of healing was 43%, and in the control group 15% (χ2, p = 0.04). The relative risk reduction was 1.9, and the number needed to treat was 3.6 (95%). Mild adverse events were observed.
Conclusions: Candidin intralesional immunotherapy is an effective and safe treatment in patients with recalcitrant warts.


Key words: recalcitrant warts, candidin, clinical trial, immunostimulation, placebo effect.


REFERENCIAS

  1. Lowy D, Androphy E. Verrugas. En: Fitzpatrick E, editor. Dermatología en Medicina General. 6ª ed. Nueva York: Panamericana, 2003;p:2396-2408.

  2. Clifton M, Johnson S, Roberson P, Horn J. Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens. Pediatr Dermatol 2003;20:268-271.

  3. Kilkenny M, Merlin K, Young R. The prevalence of common skin conditions in Australian school students: 1. Common, plane and plantar viral warts. Br J Dermatol 1998;138:840-845.

  4. Bellew S, Quartarolo N, Janniger C. Childhood warts: an update. Pediatr Dermatol 2004;73:379-384.

  5. Massing AM, Epstein WL. Natural history of warts: a two year study. Arch Dermatol 1963;87:306-310.

  6. Kirnbauer R, Lenz P, Okum M. Virus del papiloma humano. En: Bolognia J, Jorizzo J, Rapini R, editores. Dermatología. Madrid: Elsevier, 2004;p:1217-1233.

  7. Arenas R. Dermatología, diagnóstico y tratamiento. 3ª ed. México: McGraw-Hill, 2005;p:656-667.

  8. Sánchez MC. Estudio comparativo de la eficacia y seguridad del ácido pirúvico vs crioterapia en el tratamiento de verrugas plantares. Dermatol Rev Mex 2003;47:219-231.

  9. Bettley FR. The treatment of skin carcinoma with podophyllum derivates. Br J Dermatol 1971;84:74-81.

  10. Hasson A, Valdés R, Valerie C. Bleomicina intralesional en dermatología. Revisión. Dermatología CMQ 2005;3(1):15-21.

  11. Moncada B, Rodríguez ML. Levamizole therapy for multiple warts. Br J Dermatol 1979;101:327-330.

  12. Naylor MF, Neldner KH, Yeary J, Yarbrough GK, et al. Contact immunotherapy of resistant warts. J Am Acad Dermatol 1988;19:679-683.

  13. Wu J, Pang KR. Advances in antiviral therapy. Dermatol Clin 2005;23:313-322.

  14. Bacelieri R, Johnson S. Cutaneous warts. An evidence-based approach to therapy. Am Fam Physician 2005;72:647-652.

  15. Bonifaz A. Micología médica básica. 2ª ed. México: Méndez Editores, 2000;p:317.

  16. Rodríguez AM, Lizárraga GC, Jurado SCF. Intradermorreacciones en dermatología. Dermatol Rev Mex 2008;52:160-174.

  17. Benedetti F. Mechanism of placebo and placebo-related effects across diseases and treatments. Annu Rev Pharmacol Toxicol 2008;48:33-60.

  18. Hróbjartsson A, Gotzsche PC. Placebo interventions for all clinical conditions. Review. Cochrane Database of Systematic Reviews 2003, Iss 1. Art No.: CD003974. doi:10.1002/14651858. CD003974.pub2

  19. Barford T. Placebo therapy in dermatology. Clin Dermatol 1999;17:69-76.

  20. Kemeri M, Rosenwasser L, Panettieri R. Placebo response in asthma. A robust and objective phenomenon. J Allergy Clin Immunol 2007;119:1375-1381.

  21. Benedetti F, Mayberg H, Wager T, Stohler C, Zubieta J. Neurobiological mechanism of the placebo effect. J Neurosci 2005;25:10390-10402. doi: 10.1523.

  22. Goebel MU, Trebst AE, Steiner J, Xie YF, et al. Behavioral conditioning of immunosuppression is possible in humans. FASEB J 2002;16:1869-1873.

  23. Signore R. Candida albicans: an immune response modifier. Pediatr Dermatol 2004;21:512.

  24. Bonilla LA, Vera A, Benuto RE, Moren C. Candidina intralesional en el tratamiento de verrugas víricas recalcitrantes. Dermatol Rev Mex 2004;48(6):307-310.

  25. Bonilla LA, Vera A, Benuto RE, Moren C. Candidina intralesional en el tratamiento de las verrugas planas en la cara. Piel 2005;20:112-114.

  26. Horn T, Johnson S, Helm R, Roberson P. Intralesional immunotherapy of warts with mumps, Candida, and trichophyton skin test antigens, a single-blinded, randomized, and controlled trial. Arch Dermatol 2005;141:589-594.

  27. Signore R. Candida albicans allergenic extract stimulates expression of toll-like receptor 2 and toll-like receptor 9 and increase expression of toll like receptor 8 in human polymorphonuclear leucocytes. J Am Acad Dermatol 2005;32:P7.

  28. Johnson S, Roberson P, Horn T. Intralesonal injection of mumps or Candida skin test antigens. Arch Dermatol 2001;137:451- 455.

  29. Rodríguez M, Lizárraga C. Impacto de la adherencia en la efectividad de candidina intralesional vs ácido salicílico tópico al 27% en el tratamiento de las verrugas vulgares. Rev Cent Dermatol Pascua 2009;18:5-18.






>Journals >Dermatología Revista Mexicana >Year 2011, Issue 1
 

· Journal Index 
· Links 






       
Copyright 2019