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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.

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



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


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


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.


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.


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


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.


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

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