Citric acid 50% solution versus tretinoin 0.05% lotion in the treatment of plane warts

Background: The course of human papilloma virus infection varies considerably and there are many modalities of therapy, reflecting that none is uniformly effective. Objective: To evaluate and compare the efficacy of 50% citric acid solution in water versus 0.05% tretinoin lotion for the treatment of plane wart in a sample of Egyptian patients. Patients and methods: Ninety patients with plane warts were included in this randomized comparative therapeutic study with age range from 7 to 34 years. The selected patients were divided into two treatment groups, wherein group I applied 50% citric acid solution twice daily and group II applied 0.05% tretinoin lotion once daily for 8 weeks or till complete clearance. The follow-up time was 3 weeks after the final treatment. Results: There was a statistically significant difference (P 0.001) between the number of lesions before and after treatment in both groups. The duration of treatment was longer in group I with better results in patients above the age of 20 years (P 0.001) and in warts located on the dorsum of the hand (P 0.05) compared with group II, with less burning sensation and better results in younger patients. Conclusion: Fifty percent citric acid solution appears to be a promising self-treatment option from the perspective of both cost and effectiveness in comparison with the efficacy of 0.05% tretinoin lotion in treating plane warts.