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Efficacy and safety of oral isotretinoin in treatment of plane warts


Introduction: Plane warts is one of the commonest viral infections which may be resistant to many treatment modalities, isotretinoin has been shown effectiveness in many HPV (human papilloma virus) infections. This study aimed to assess the efficacy and safety of oral isotretinoin in the treatment of plane warts. 

Methods: A prospective clinical trial study was conducted in Erbil Dermatology Center in Erbil city, Kurdistan region through the period from 1st of July 2019 to 5th of January 2020. Forty patients with plane warts included. All patients received isotretinoin in a dose of 0.5 mg/kg/day in two divided doses for three months and patients were assessed monthly clinically and by investigations. After last dose patients were followed up for three months to see any recurrence.

Results: After three months of therapy 15 patients (37.5%) showed complete response while only 2 patients (5%) showed partial response and the remaining had significant reduction in number of their plane warts during this period. During the 3 months therapy, comparing the results after 1st, 2nd and 3rd month, there was significant increase in number of patients who achieved complete response at the end of three months with (p=0.003). At the end of three months follow up, only 2 patients out of 15 who achieved complete response revealed recurrence while remainder 13 were still free of disease. All the adverse effects of isotretinoin during treatment period were mild and reversible with no recorded serious adverse effects.

Conclusion: Oral isotretinoin is effective and safe in treatment of plane warts.



  1. Leman JA, Benton EC. Verrucas. Guidelines for management. Am J Clin Dermatol. 2000;1(3):143-149.
  2. Ciconte A, Campbell J, Tabrizi S, Garland S, Marks R. Warts are not merely blemishes on the skin: A study on the morbidity associated with having viral cutaneous warts. Australas J Dermatol. 2003;44:169-173.
  3. Atawane M, Makhecha M, Singh T, Yadav T.Efficacy and safety of oral isotretinoin in the treatment of viral warts- a hospital based interventional study. Sch. J. App. Med. Sci. 2018;6(9):3331-3338.
  4. Akyol M, Özçelik S. Non-acne dermatologic indications for systemic isotretinoin. American journal of clinical dermatology. 2005;6(3):175-184.
  5. McGarth GA, Eady RA, Pope FM. Rook's Textbook of Dermatology, 9th Edition. Blackwell Publishing Ltd 2016. Chapter 33. pp. 1532.
  6. James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM (eds.). Andrews diseases of the skin: Clinical Dermatology 13th edition. Elsevier. 2019. pp. 1211.
  7. Kang S, Amagai M, Bruckner AL, Enk AH, Margolis AJ, McMichael AJ, et al (eds). Fitzpatrick's Dermatology 9th edition. Mc Graw Hill Education. 2019. Chapter 22. pp. 3918-3919.
  8. Bolognia JL, Schaffer JV, Cerroni L (eds.). Dermatology 4th edition. Elsevier. 2017. Section 19. pp. 126.
  9. Woodby B, Scott M, Bodily J. The interaction between human papillomaviruses and the stromal microenvironment. Prog Mol Biol Transl Sci. 2016;144:169–238.
  10. Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield-Jones SE. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol. 2014;171(4):696-712.
  11. Al-Hamamy HR, Salman HA, Abdulsattar NA. Treatment of plane warts with a low-dose oral isotretinoin. ISRN Dermatol .2012;2012:163929.
  12. Al Obaidi H. Topical 5 fourouracil versus topical tretinoin 0.05% in treatment of plane wart: randomized controlled comparative trial. Global J Bio-Science and Biotechnology. 2013;3:368-372.
  13. Akyol M, Ozçelik S. Non-acne dermatologic indications for systemic isotretinoin. Am J Clin Dermatol, 2005;6:1751-1784.
  14. Torzecka JD, Dziankowska-Bartkowiak B, Gerlicz-Kowalczuk Z, Wozniacka A. The use of isotretinoin in low doses and unconventional treatment regimens in different types of acne: a literature review. Adv Dermatol Allergol. 2017;34:1-5.
  15. Salih H, Fadeel B. Evaluation of isotretinoin gel and oral zinc sulphate in the treatment of plane warts. J Fac Med Baghdad. 2008;50:448-450.
  16. Gelmetti C, Cerri D, Schiuma AA, Menni S. Treatment of extensive warts with etretinate: A clinical trial in 20 children. Pediatr Dermatol. 1987;4:254-258.
  17. Ozturk M, An I. A case of flat wart that responds perfectly to isotretinoin. Ann Med Res. 2019; 26(1):125-126.
  18. Yang T-H, Lee T-H, Huang Y-C. Oral isotretinoin for treating mucocutaneous human papillomavirus infections: A systematic review and meta-analysis. Indian J Dermatol Venerol Leprol. 2019;85:569-577.
  19. Kaur GJ, Brar BK, Kumar S, Brar SK, Singh B. Evaluation of the efficacy and safety of oral isotretinoin versus topical isotretinoin in the treatment of plane warts: a randomized open trial. Int J Dermatol. 2017;56(12):1352-1358.
  20. Olguin-García MG, Jurado-Santa Cruz F, Peralta-Pedrero ML, Morales-Sánchez MA. A double-blind, randomized, placebo-controlled trial of oral isotretinoin in the treatment of recalcitrant facial flat warts. J Dermatolog Treat. 2015; 26(1):78-82.
  21. Gupta R, Agarwal US, Meena RS. A double blind placebo controlled trial to compare the effect of oral isotretinoin and tretinoin (0.05%) cream combination with tretinoin (0.05%) cream alone for treatment of cutaneous warts. JDA Indian Journal of Clinical Dermatology.2018;1:19-22.
  22. Bia?ecka A, M?ci?ska-Jundzi?? K, Adamska U, Cichewicz A, Bia?ecki M, Drewa G, et al. Plane warts on the back of the hand successfully treated with oral isotretinoin. Adv Dermatol Allergol. 2018;XXXV(2):227–229.
  23. Marron SE, Tomas-Aragones L, Boira S. Anxiety, depression, quality of life and patient satisfaction in acne patients treated with oral isotretinoin. Acta Derm Venereol. 2013;93(6):701-706.

How to Cite

Nooruldeen, A. D., & Saeed, M. Y. (2021). Efficacy and safety of oral isotretinoin in treatment of plane warts. Bali Medical Journal, 10(3), 1076–1080.




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Asan Duraid Nooruldeen
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Mohammed Yousif Saeed
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