الفهرس 
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Abstract
Cutaneous warts are the most common cutaneous infection occurring when immune function is impaired, for example after organ or bone marrow plant or due to severe combined immune deficiency; cutaneous warts may be large, extensive and resistant to treatment. Cutaneous warts are caused by the human papillomavirus. Small defects of the skin are sufficient to allow the virus to infect the basal layer of the skin, which may lead to benign hyperkeratosis papillomata.
Cutaneous warts are widespread in the worldwide population. Cutaneous warts occur in 7% to 10% of the general population, with incidence peaking between the ages of 12 and 16 years. Cutaneous warts Occur equally in both sexes in children ages 2 to 12 years and are among the three most common dermatomes treated. IL-17 deficiency models have increased risk of bacterial infection with increased bacterial load and dissemination, delayed neutrophil recruitment and clearance of bacteria, and more severe infections. Risk of fungal and viral infections is also increased in IL-17 deficiency states.
It has been found that serum levels of IL-17 significantly decreased in patients with leprosy. The lowest serum levels of IL-17 were found in lepromatous leprosy. It seems that defective secretion of IL-17 has a role in leprosy progression, which depends mainly on cell-mediated immunity defect.
The aim of the current study was to identify the possible role of Serum Level of Interleukin -17 in occurrence, number and recurrence of different types of warts in patients by ELISA and compare the result with healthy control participants.
A clinical trial study was carried out on 75 patients with the diagnosis of CW, and 15 healthy age and sex matched controls. The patients were randomly selected from those attending at the attending to October 6 University Hospital outpatient’s clinic in the period from October 2017 to December 2018 years. Clinical and laboratory data of the studied groups were tabulated and statistically analyzed.
This study was conducted on 100 subjects, divided into two groups:
group I (patients): including 75 patients with the diagnosis of cutaneous warts (CW).
group II (control group): including 30 normal healthy subjects of matched age and sex served.
Inclusion criteria: Patients with the diagnosis of CW.
Exclusion criteria:
Pregnant and lactating females
Concomitant treatment of warts
Concomitant intake of immunosuppressive drugs (cyclosporine, azathioprine, and methotrexate)
Systemic diseases (diabetes, hypertension, and renal or heart diseases).
For all subjects the following procedures were performed:
Careful history taking regarding:
Personal history: Name, Age, Sex, Address, Residence, Occupation, Marital status and Special habits (smoking, alcohol).
Past history: Any medical disease and its nature, duration, treatment. And Any drug intake and its regimen and duration of intake.
Present history: Onset, Course, Duration, Site, Number, recurrence and Previous treatment.
Family history: Of any similar condition.
Thorough clinical examination:
With stress on onset, course, duration of the warts, number of warts, types of warts, family history of warts, history of recurrence of warts, different types, activity of any new lesion and interval warts).
Dermatological examination: full dermatological examination was done including skin, hair and nails.
Local examination of the lesion reporting upon: number, size, site, extent and presence of secondary bacterial infection.
Acetowhite test: the acetowhite test has been recommended to help determine the extent of the affected area.
The results of our study were:
There was no significant statistical difference between patients with cutaneous warts and control groups regarding to their age, sex, residence, marital status and history of smoking.
18.67% of patients had positive family history of warts and 81.33% had negative family history. 23 (30.67%) and 34 (45.33%) of patients had warts recurrence once and twice, respectively. While, 18(24%) of patients hadn’t Warts recurrence.
36 (48%) of patients had duration of skin disease less than 6 months followed 23 (30.67%) of patients had 6 month-1 years. While only 16(21.33%) had more than 1 year.
Warts numbers among the studied patients varies between one (20=26.67%) to eight (2=2.67%). Number of warts less than 5 was the most common 56(74.67%) among the studied patients.
Regarding diseases onset, 40(53.33%) of patients had sudden and 35(46.67%) had gradually. Also, 44(58.67) of patients had Progressive course followed 27(36%) of patients had Stationary. While only 4 (5.33%) had regressive course.
There was a significant statistical difference between patients with cutaneous warts and control groups regarding to Serum level of IL 17. Patients had significantly lower serum level of IL 17 (113.5±37.12) than control group (167.11±43.11).
Serum level of IL17 was significantly correlation with twice or more recurrent cases (P=0.015), sudden onset cases (P=0.002), disease duration more than 1 year (p=0.017). No correlation found (p>0.05) between course of disease and serum level of IL17.
Serum level of IL17 was significantly lower in genital cases than Palmo-planter and than common warts with Genital cases (P=0.007), followed by Palmo-planter cases (P=0.015), then common cases (p=0.028).
Number of warts <5 was positively correlated with serum level of IL.17 among palmo-planter and genital types. Also, number of warts ≥5 was positive correlation with serum level of IL.17 among common, palmo-planter and genital types.
Level in recurrence once was positive correlation with serum level of IL.17 among palmo-planter and genital types. While, level in twice or more recurrence was positive correlated with serum level of IL.17 among common, palmo-planter and genital types.
Level in sudden onset was positive correlation with serum level of IL.17 among palmo-planter and genital warts. Moreover, level in progressive course was positive correlation with serum level of IL.17 among common, palmo-planter and genital types.
Duration of skin disease more than 1 year was positive correlation with serum level of IL.17 among commune warts type.