Variation in the Outcome following Intralesional 5-FU in the Treatment of Various Forms of Cutaneous Warts in Iraqi Patients based on Clinical Presentation

Aims The current study was conducted to see the safety and efficacy of intralesional 5-FU in treating cutaneous warty lesions in a sample of Iraqi patients. Methods This experimental study was conducted in patients with various warty skin lesions from August 2020 to August 2021. Sixty patients visited the dermatology unit at Aldiwaniyah teaching hospital, Iraq, and were selected for the study. The new solution containing 4mL of 50mg/mL 5-fluorouracil was injected strictly intralesionally till blanching of the lesion occurred. After two weeks of 5-fluorouracil injection, a black ecchymosed eschar developed, which was pared, and residual warts, if present, were injected a second time. The patients were followed up to 3 months and then quarterly up to 1 year. Persistence of wart after three months of the last injection was taken as a failure of treatment. The statistical analysis was done with the SPSS 16 and Excel 2007 using the Chi-square test. Findings The complete response to treatment was seen in 200 (80.0%), partial response was seen in 37 (14.8%), and no response was recorded in 13 (5.2%) of cases. There was no significant association between size of warty lesion and response to intralesional 5-FU (p=0.154); however, there was a significant association between type of warty lesion and response to intralesional 5-FU (p=0.046). Conclusion Intralesional 5-FU appears to be highly effective in treating cutaneous warts; however, the response is influenced by the type of skin lesion, being maximal with palmoplantar wart and least common with the skin lesion periungual lesions.