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Successful treatment of doughnut warts with intralesional Candida antigen immunotherapy
Ahmad Nofal1,2, Ibrahim Fouda2,3, Hany Aboelwafa2,3
1Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Background:
Doughnut warts, also called ring or annular warts, are a distinctive type of warts with central clearing and annular recurrence. There are very few studies illustrating this uncommon phenomenon and its treatment.
Aims:
To present 15 cases of doughnut warts and evaluate the efficacy and safety of Candida antigen intralesional immunotherapy in their treatment.
Methods:
The study included 15 patients presenting with doughnut warts who were previously treated with destructive modalities for their original warts. All patients were injected intralesionally by Candida antigen at a dose of 0.2 mL into the base of doughnut wart until complete clearance or for a maximum of 5 sessions.
Results:
Complete clearance was achieved in 12 patients (80%), partial response in 2 patients (13.3%), and no response in 1 patient (6.7%). Complete response was observed after two sessions in 5 patients, after three sessions in 4 patients, and after four sessions in 3 patients. Adverse effects were minimal and insignificant.
Conclusions:
Doughnut warts represent a unique and rare type of wart recurrence. Intralesional Candida antigen immunotherapy seems to be a promising and effective therapeutic modality for the treatment of such a rare entity.
