الفهرس 
Cutaneous WartsOnly 14 pages are availabe for public view
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Abstract
Cutaneous warts are the result of infection of the epidermis with human
papilloma virus (HPV). Different HPV types are responsible for particular clinical
varieties such as common, plane, plantar, mosaic, ano-genital and oral warts.
Warts are refractory to treatment. Many lines of treatment are available but
none is eradicative and most of them have limited efficacy and show relapse.
Numerous therapeutic modalities are available for warts with variable success
rates. These include topical therapies such as salicylic acid, tretinoin,
podophyllotoxin, trichloroacetic acid, formaldehyde, 5-fluorouracil,
immunomodulating agents, photodynamic therapy, systemic retinoids,
surgical/cytotoxic modalities such as cryotherapy, laser ablation, intralesional
bleomycin, electrocautery, and surgical excision.
Warts become recalcitrant after conventional treatment for several months
such as, 12 week of salicylic acid application, 4 or more cycles of cryotherapy or
electrocautery and/or other physical treatment modalities.
Vitamin A is a fat solubale vitamin, has several natural and synthetic
forms. Vitamin A plays an important role in epithelial cell differentiation, keratin
expression and immunity. Retinoids are synthetic forms of vitamin A, which
showed great succeful rate for the treatment of recalcitrant warts, by their topical
or systemic forms.
Vitamin A is transported to the tissues in the form of retinol bound to a
protein produced by the liver called retinol binding protein (RBP) which present
in circulation in equimolar concentrations with retinol, in addition to refrigeration
and laboratory facilities for RBP are cheaper than those of retinol, also more
accurate results may be obtained from measuring RBP than measuring retinol as
an indicator of vitamin A status in the body.
So our aim in this study was to evaluate the serum RBP level as an
indicator of vitamin A status in resistant cutaneous warts patients to assess its
correlation to the disease pathogenesis.
This case control study was conducted on 60 subjects, who were divided
into two groups, group (1) included 30 cases of recalcitrant cutaneous warts after
conventional treatment for several months as 12 week salicylic acid application, 4
or more cycles of cryotherapy or electrocautery and/or other physical treatment
modalities, group (2) included 30 apparently healthy subjects of matched age and
sex, who were chosen as a control. Patients were selected from the dermatological
outpatient clinic, Faculty of Medicine, Menoufia University Hospital, during the
period from July 2019 to November 2019.
All the studied groups were subjected to complete history taking. Both
general and dermatological examination were performed. Venous blood sample
(3ml) was collected from every subject under complete aseptic condition, left to
coagulate at room temperature, then centrifuged at a speed of 4000 r.p.m for 10
minutes. The serum obtained was stored at -20 c until analysis of serum RBP by
an enzyme linked immunosorbent assay (ELISA) technique.