Intralesional 5‑Fluorouracil in the Management of Resistant Warts: Outcomes from a Single-Arm Clinical Trial

Ethar Falah Hasan; Noor Subhi Fadhil; Dhuha Amer Khudhair

doi:10.54133/ajms.v10i2.2903

Authors

Ethar Falah Hasan Department of Medicine, College of Medicine, Al Nahrain University, Baghdad, Iraq https://orcid.org/0000-0003-0736-8361
Noor Subhi Fadhil Al-Imamin Al-Kadhimain Teaching Hospital, Baghdad, Iraq
Dhuha Amer Khudhair National Center for Allergy, Asthma and Immunology, Baghdad, Iraq

DOI:

https://doi.org/10.54133/ajms.v10i2.2903

Keywords:

Intralesional 5-FU, HPV , Resistant warts

Abstract

Background: Treating resistant warts is inconvenient and frustrating both for patients and for treating physicians. One possible therapy option is 5-fluorouracil, an antimetabolite that has shown better results when administered intralesionally rather than topically. Objective: To evaluate the efficacy and safety of intralesional 5-fluorouracil in treating warty lesions not responding to other options of treatment in a sample of Iraqi patients. Methods: A single-arm clinical trial study conducted in Al-Imamain Al-Kadhmain Medical City, Baghdad, Iraq, during a period of 18 months from March 2024 to September 2025. It included 110 patients diagnosed with warts not responding to different treatment options for at least one year. Each patient received an intralesional 5-fluorouracil injection in each session, repeated every two weeks for four sessions or less if the lesions are completely resolved. Results: The differences in mean size and number of warts during visits were significantly decreased (p<0.05) compared to baseline size. The level of pain significantly decreased after six weeks compared to that after two weeks (p=0.001), and no pain was reported after three months. The level of satisfaction of patients significantly increased after three, six, and 12 months compared to that after two weeks (p=0.001). Conclusions: To treat warts that typically don't react to conventional treatments, intralesional 5-FU may represent a promising therapeutic option. It shows promise as a primary treatment for resistant warts.

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