There is a multitude of topical preparations and therapeutic strategies for the treatment of common warts but none of them is universally preferred. Topical hydrogen peroxide, a remarkably safe agent in low concentrations has been recently reported to be effective in wart therapy while cantharidin, a strong blistering agent has been known over years as one of the standard topical preparations.
The incidence of warts has been reported to increase in immunosuppressed allograft recipients as well as in patients with certain immunodeficiency syndromes, especially those with a defective cell mediated immune response. Host defense against HPV relies on intact and functioning cellular immunity including T-cell and natural killer cell cytotoxicity. Therefore, in patients in whom warts are severe or recalcitrant, concern for immune defects is raised, and it may be presumed that the macrophage migration inhibitory factor (MMIF) has a role in this respect (15). This cytokine is a critical immune regulatory factor, playing a role in the regulation of macrophage function in host defense by regulation of a number of proinflammatory cytokines including tumor necrosis factor (TNF) and interleukin-1 (IL-1)

AIM OF THE WORK

1. To make a controlled study of the efficacy and safety profile of cantharidine-podophyllin resin salicylic acid formulation in comparison with hydrogen peroxide cream in the treatment of recalcitrant common warts of the hands.
To correlate the therapeutic effect of these topical agents with the basic pretreatment serum level of macrophage migration inhibitory