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Indian J Dermatol Venereol Leprol. 2019 Jul 5. doi: 10.4103/ijdvl.IJDVL_269_18. [Epub ahead of print]

Oral isotretinoin for treating mucocutaneous human papillomavirus infections: A systematic review and meta-analysis.

Author information

1
Department of Dermatology, Wan Fang Hospital; Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
2
Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University; Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan.

Abstract

Introduction:

Some viral warts are refractory to treatment, some others tend to recur. Oral isotretinoin is useful against warts to varying degrees.

Objective:

To determine the efficacy of oral isotretinoin for treating mucocutaneous human papillomavirus infections.

Methods:

A systematic review and meta-analysis of studies published from the date of inception of the databases to December 30, 2017 were conducted. Randomized controlled trials or case series with ≥10 patients with mucocutaneous human papillomavirus infection who had received oral isotretinoin treatment were analyzed. The meta-analysis estimated the pooled odds ratio and pooled response rate.

Results:

The review included eight studies. Trials of oral isotretinoin versus placebo treatment revealed that isotretinoin effectively treated mucocutaneous human papillomavirus infections (odds ratio: 43.8, 95% confidence interval: 9.7-198.8). The pooled estimate of the complete response rate of oral isotretinoin to mucocutaneous human papillomavirus was 67.7% (95% confidence interval: 49.5-81.7%). Another pooled estimation revealed that 83.9% (95% confidence interval: 59.7-94.9%) of patients exhibited at least 50% lesion clearance, whereas 12.3% with complete response experienced recurrence.

Limitations:

This meta-analysis had a small sample size and high inter-study heterogeneity.

Conclusion:

Oral isotretinoin is superior to placebo for treating mucocutaneous human papillomavirus infections, particularly plane warts. The recurrence rate and risk of severe side effects are low.

KEYWORDS:

Condyloma acuminatum; mucocutaneous human papillomavirus infections; oral isotretinoin; retinoids; warts

PMID:
31274470
DOI:
10.4103/ijdvl.IJDVL_269_18
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