Methylene Blue Photodynamic Therapy Versus Tuberculin Purified Protein Derivative (PPD) Immunotherapy in Plane Warts in Children

Background: Plane warts are caused by human papilloma virus (HPV) (most often HPV‐2, HPV‐3 or HPV‐10) and generally multiple, slightly elevated, smooth papules occurring most often on the face, hands, neck, and legs of children and young adults. Objective: To compare the efficacy and safety daylight photodynamic therapy using methylene blue versus tuberculin purified protein derivative (PPD) immunotherapy intradermal injection in plane warts in children. Patients and methods: Forty patients (Children) complaining of plane warts were enrolled in this study. They were randomly selected from the attendants of out-patient clinic Dermatology and Venereology Department, Al Hussein University Hospital, Faculty of Medicine, Al-AzharUniversity from April 2019 to November 2019. Patients were divided randomly into two groups, to undergo either methylene blue day light photodynamic therapy (MB-DL PDT) or tuberculin PPD intradermally. Results: Tuberculin PPD-treated group showed significantly higher rates of complete response compared with MB- DL- PDT-treated group, complete response (60% versus 30% respectively); partial response (10% versus 30%), and no response (30% versus 40%). Conclusion: PPD intradermally and MB-DL PDT has significant advantages over other treatments. Most treatment modalities were painful, needing multiple visits (time and money consuming), and were directed to each individual wart. This study confirmed that immunotherapy tuberculin PPD and MB-DL-PDT can be used to treat cutaneous Plane warts in children.