Comparative Efficacy of Intralesional MMR and Vitamin D₃ Immunotherapy in Cutaneous Warts: A Randomized Controlled Trial with Clinical and Dermoscopic Assessment

Background: Cutaneous warts are common benign epidermal proliferations caused by human papillomavirus. Conventional destructive therapies are associated with pain, scarring, and recurrence. Intralesional immunotherapy and dermoscopic assessment have emerged as effective alternatives for treatment and monitoring. The aim is to compare the efficacy and safety of intralesional Measles-Mumps-Rubella (MMR) vaccine and intralesional Vitamin D3 in the treatment of cutaneous warts using clinical and dermoscopic assessment. Material and Methods: Prospective randomized controlled study conducted in the Department of Dermatology, Venereology and Leprology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad. One hundred twenty-two patients with clinically diagnosed cutaneous warts were randomized equally into two groups. Group A received intralesional Vitamin D3 and Group B received intralesional MMR vaccine at 3-week intervals for a maximum of four sessions. Clinical and dermoscopic evaluations were performed at baseline and follow-up visits. Statistical Analysis Used: Data were analyzed using SPSS version 26.0. Appropriate descriptive and inferential statistical tests were applied, with p<0.05 considered statistically significant. Results: The mean age was 32.15±11.66 years, and 57.4% of participants were males. Both treatment modalities demonstrated significant clinico-dermoscopic improvement, including reduction in papillomatous surface changes, thrombosed capillaries, and vascular structures, with favorable clearance rates and minimal adverse effects. Conclusion: Intralesional MMR vaccine and Vitamin D3 are effective, safe, and economical treatment options for cutaneous warts. Dermoscopy provides an objective, non-invasive tool for monitoring therapeutic response and lesion resolution.

Keywords: Cutaneous warts; Human papillomavirus; Intralesional immunotherapy; MMR vaccine; Vitamin D3; Dermoscopy.