The following is the summary of “Emerging Intralesional Treatments for Plantar Warts: A Systematic Review” published in the December 2022 issue of Dermatology by Martin, et al.

There is still much room for interpretation and clarity in plantar wart therapies, which has kept researchers on the hunt for a better solution. This has led to the development of a plethora of intralesional therapies over the past decade. This calls for a clinically-oriented systematic review of the most recent developments in intralesional therapy for plantar warts. Following the recommendations in the PRISMA statement for systematic reviews, investigators searched the PubMed/MEDLINE databases. 

Published between January 2012 and January 2021, original peer-reviewed studies on the safety/efficacy of intralesional plantar wart therapies were examined for inclusion. About 26 studies were included in the meta-analysis, and the median cure rates for intralesional modalities were as follows: vitamin D3 (80%), bleomycin (74%), 5-fluorouracil (59%), Candida antigen (66%), zinc sulfate (70%), and pure protein derivative (67%). Although not widely available in the United States, intralesional vitamin D3 has shown promise as a potential second or perhaps first-line agent.

Although intralesional vitamin D3 has been shown to be the most effective treatment for plantar warts, alternative options, such as Candida antigen and bleomycin, should be tried for stubborn cases if cryotherapy fails. In addition, further research is needed into the efficacy of the quadrivalent human papillomavirus (HPV) vaccine in treating and preventing plantar warts.