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Topical cyclosporin a in the treatment of viral warts

Topical cyclosporin a in the treatment of viral warts

Abstract

Journal o Dermatological Treatment (1992) 3 159 - I61 f : Journal of Dennatological Treatment. 1992 Correspondence Topical cyclosporin A in the treatment of viral warts Sir, Warts, also known as ‘verrucae vulgares’, are an infection of the skin and mucous membranes by human papilloma virus (HPV). The virus infects epidermal cells by direct inoculation of epithelia and is responsible for benign hyperproliferation of the cutaneous or mucosal epithelia. HPV exhibits a strict specificity fof epithelial cells, ie keratinocytes, the differentiation of which seems to control viral expression.’ Probably keratinocytes, antigenically stimulated by HPV, cause the release of cytokines such as interleukin-1 (IL-1), IL-6, thymopoietin, macrophage colony-stimulating factor (M-CSF) or transforming growth factors. Keratinocytes have IL-1 receptors on their surface and can potentially respond to IL-1 in an exocrine fashion. IL-1 is mitogenic and chemotactic for human keratinocytes and so may cause them to hyperproliferate.2 We were interested to read the conflicting reports of Schulze et al.’ that topical cyclosporin A (CyA) ointment (5%) is of no benefit in psoriasis and of Ho et al.’ that intralesional CyA (17 mg/ml) is beneficial in psoriasis. As both psoriasis and viral warts exhibit keritinocyte hyperproliferation, and as cyclosporin is effective
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