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Abstract Researchers are still trying to find an ideal treatment modality for warts which should be curative, painless, without side effects, and with no recurrence. Current treatment options include topical, intralesional and surgical lines. There is no single treatment that is 100 percent effective; several types of treatment may be combined. A wide variation of treatment modalities is available for the management of warts. The range of topical treatment modalities includes duct tape, topical salicylic acid, cryotherapy, silver nitrate, mono-chloroacetic acid, podophyllin, cantharidin, and 5-fluorouracil. Hydrogen peroxide is a chemical compound with the formula H2O2. HP is formed in human body as a short-lived product in many biochemical processes. It is one of the reactive oxygen species (ROS), and it demonstrates a broad-spectrum activity against viruses, bacteria, yeasts, and fungal spores. HP was previously tried successfully as a topical treatment for molluscum contagiosum (MC) and in warts. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 20% podophyllotoxin and 30% salicylic acid (CPS). The present study aimed to make a controlled assessment 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 and to correlate the therapeutic effect of these topical agents with the basic pretreatment serum level of macrophage migration inhibitory factor. This is a cross sectional study that was carried out in the Dermatology Outpatient Clinic of the Alexandria Main University Hospital on subjects including 5 groups: (group I); included 20 patients with multiple recalcitrant common warts of the hands treated with cantharidine podophyllin resin salicylic acid formulation, and estimated for macrophage migration inhibitory factor (MMIF), (group II); included 20 patients treated with hydrogen peroxide cream 1%, and estimation of the serum level of MMIF, (group III); included 20 patients recruited for placebo treatment (panthenol cream), (group IV); included 20 healthy subjects within the same range of age as group I, II and III, all groups were selected for estimation for macrophage migration inhibitory factor (MMIF), additional 10 patients were recruited for treatment by H2O2 5% cream (group V). |