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242/107201186/p1/article.jhtml Eighty patients (mean age, 20
years) with treatment-resistant viral warts (common, plantar
and plane; more than 15 warts per person), with a disease
duration of 1-10 years, were randomly assigned to receive,
in single-blind fashion, oral zinc sulfate (10 mg/kg of body
weight/day, to a maximum of 600
mg/day) or placebo for two months. Only 23 patients in the
zinc group and 20 in the placebo group completed the
study; the reasons for withdrawal were not specified. At
baseline, the mean serum zinc concentration was
approximately 27% lower in the patients than in healthy
controls, although none of the patients had signs or
symptoms of zinc deficiency. In the zinc-treated group,
20 of 23 patients (86.9%) had complete disappearance of
warts after 2 months, and 14 (60.9%) had complete
disappearance of warts after 1 month. No patient in the
placebo group improved. Signs and symptoms of wart
regression occurred in all patients treated with zinc:
these included itching, tenderness, and a transient
increase in the size or number of warts. Side effects of
zinc included nausea in all patients, vomiting in
21.7%, and epigastric pain in 13%. These side effects were
mild and transient and did not necessitate stopping
treatment.
Comment: The results of this study indicate that oral zinc
sulfate is effective in the treatment of chronic viral
warts. The maximum dose of 600
mh/day of zinc sulfate is equivalent to 135 mg/day of
elemental zinc. It is possible that smaller (and less
nauseating) doses of zinc would also be effective, if
better absorbed forms were used, such as zinc picolinate
or zinc citrate. Although the dropout rate was nearly
50%, the high response rate among patients who completed
the study is noteworthy.
Al-Gurairi FT, et al. Oral zinc sulphate in the treatment of
recalcitrant viral warts: randomized placebo-controlled
clinical trial. Br J Dermatol 2002;146:423-431.
Alan R. Gaby, MD
301 Dorwood Drive * Carlisle, Pennsylvania 17013
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Gale Group