A Comparative Clinical Study of Intralesional MMR Vaccine and Vitamin D3 in the Treatment of Cutaneous Warts

Abstract

Cutaneous warts are frequent benign proliferations resulting from Human Papillomavirus (HPV). Conventional destructive therapies are often painful with frequent recurrences. Intralesional immunotherapy has emerged as an effective substitute by stimulating cell-mediated immunity. To compare the safety and effectiveness of the intralesional Measles, Mumps, and Rubella (MMR) vaccine versus intralesional vitamin D3 in the management of cutaneous warts in terms of response rate, speed of improvement, and complete clearance. This prospective randomized comparative research involved sixty cases with nongenital cutaneous warts, conducted from May 2024 to May 2025. Cases were randomly separated into two equal groups (number=30 each). Group A received the intralesional MMR vaccine (0.2 mL into the largest wart), and Group B received intralesional vitamin D3 (0.2 mL per wart after local anesthesia). Injections were repeated every two weeks for a maximum of 6 sessions. The response was assessed clinically as complete, partial, minimal, or no response. Insignificant variances have been observed among both groups regarding overall response rate or percentage of improvement (p > 0.05), with complete response achieved in 76.7% of the MMR group and 63.3% of the Vitamin 3 group. However, vitamin D3 required significantly fewer sessions (mean 3.01 ± 0.93) compared to MMR (mean 5.69 ± 0.62) (p < 0.001). Both treatments were well tolerated. Both intralesional vitamin D3 and the MMR vaccine are safe and efficient for cutaneous warts. Vitamin D3 offers the advantage of faster clearance with fewer treatment sessions.