Prathyusha Yakkala1, Rachita Dhurat2, Meghana Phiske3
BACKGROUND
Diphenylcyclopropenone (DPCP) produces type IV hypersensitivity reaction,
immune response being directed against a complex of contact agent hapten bound
to proteins of viral origin that enhance wart regression. We wanted to evaluate
the efficacy and safety of DPCP in multiple warts along with the various factors
affecting DPCP response.
METHODS
A prospective study with 49 patients older than 5 years with 5 or more warts in
any area (except genital) was conducted. Patients were sensitized with 2 % DPCP
solution and examined after 48 hours. Sensitization was graded as mild, moderate,
severe or no sensitization. Patients with mild / moderate sensitization were further
applied DPCP; patients with severe sensitization were included after subsidence of
reaction and patients with no sensitization were excluded. After sensitization,
weekly applications were made on warts. Concentration causing mild reaction was
selected as optimal and was applied till lesion clearance. Follow up was for 3
months for recurrences. Response was graded as complete, partial and no
response.
RESULTS
Males outnumbered females. Mean age was 23 years. Mean duration was 12
months. Recurrent and resistant warts were seen in 15 and 6 patients
respectively. Mean number of warts was 15.6. 49 patients were tested for
sensitization, 1 failed sensitization and 48 were continued with weekly DPCP. 2
developed distant eczematisation and 4 were lost to follow up. Out of 42, complete
clearance was seen in 35 (83.3 %), partial in 3 (7.14 %) and no response in 4
(9.52 %). Local eczematisation, lymphadenopathy, hyperpigmentation were the
side effects. Response was better with increasing age. Warts less than 6 months
had 100 % response. There was no statistically significant difference between site
and type of warts and response to DPCP, recurrent and untreated warts in terms
of response and response to sensitization and final response.
CONCLUSIONS
DPCP is an excellent option for multiple / resistant warts with good safety profile.
