الفهرس 
Human Papilloma VirusOnly 14 pages are availabe for public view
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Abstract
Verruca plana is a common, benign viral infection of the skin caused by HPV. They are associated with cosmetic and social problems and effective treatments are limited despite the existence of a variety of treatment methods. Immunotherapy has an advantage over traditional treatment in that it enhances recognition of the virus by the immune system. Intralesional injection of C. albicans antigen for warts has previously been reported effective by stimulating a cell mediated immune response. Though it is injected intralesionally the sensitization it produces may also result in clearance of non injected distant warts. Bleomycin has an anti-tumour, anti-bacterial and anti-viral activity which may be related to its ability to bind with DNA causing bleomycin strand scission and elimination of pyrimidine and purine bases. Five- fluorouracil is a fluorinated pyrimidine which interferes with the synthesis of DNA and RNA , so 5-FU may be an effective treatment for viral warts. The aim of this study was to evaluate and compare the efficacy and safety of intralesional injection of candida albicans antigen, bleomycin and 5- fluorouracil in treatment of verruca plana. In the current study, 60 patients diagnosed as having VP completed the study. Patients were divided into three equal groups. group (A) included 20 patients who were treated using C. albicans antigen, group (B) included 20 patients who were treated with intralesional injection of bleomycin, while group (C) included 20 patients who were treated with intralesional injection of 5-FU. Regarding the degree of clinical response in group A, 12 patients (60%) showed complete cure and 8 patients (40%) showed no response, while in group B, 17 patients (85%) showed complete cure and 3 patients (15%) showed partial response and in group C, 9 patients (45%) showed complete cure, 5 patients (25%) showed partial response and 6 patients (30%) showed no response. There was a statistically significant difference among the three studied groups, regarding the clinical response to treatment. A statistically significant better response was achieved with bleomycin in comparison with either C. albicans antigen or 5-FU. Moreover, C. albicans antigen yielded a statistically significant better response when compared with 5-FU. There was a statistically significant difference between groups according to the number of sessions needed for best results, where a statistically significant less number of sessions was required to achieve best results with bleomycin and C. albicans antigen immunotherapy when compared with 5-FU. Regarding side effects, the three studied groups showed different mild side effects which were tolerable and transient. The pain during injection reported in all patients (100%) in the three studied groups. No recurrence was noticed in cured patients of studied groups during the follow up period. Regarding relation between response to treatment and different parameters in different studied groups, in group A, there was a statistically significant better response in male patients in comparison to females, while there was no significant relation between the response to treatment and other parameters. In group B, there was a statistically significant better response in patients who didn’t receive any treatment for VP than those who were refractory to other therapeutic modalities before joining the study, while there was no significant relation between the response to treatment and other parameters. In group C, there was no significant relation between the response to treatment and any of the patients criteria was detected.