الفهرس 
VIRAL WARTS
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Abstract
Viral warts are one of the most common viral infections of humans. These are caused by human papillomavirus (HPV). There are approximately 100 genotypes of these DNA viruses.
Transmission of HPV occurs most commonly by direct contact with individuals who may be harboring subclinical or manifesting clinical HPV-associated lesions, or by indirect means such as through contaminated surfaces and objects.
A thickened warty papule on the skin or mucous membrane is the typical clinical presentation. The most common sites involved are the hands, feet and the face. Prevalence rates are higher in children and young adults.
The immune system plays an important role in wart regression depending mainly on cell mediated immunity and different cytokines such as TNF-α. However, HPVs can efficiently evade the immune mechanisms.
Recovery from the viral infection is spontaneous in majority of the cases but may take months to years. There is currently no specific antiviral therapy available to cure HPV infection. Existing modalities of treatment vary from the destructive method like electrocautery, cryotherapy which involve destruction or removal of visible lesions but do not prevent recurrences and may even result in scarring to immunomodulator methods such as oral zinc sulfate and intralesional injection of candida, MMR and PPD antigen.
In this study, we evaluated the effectiveness of oral zinc sulfate as a monotherapy of viral warts as well as investigated its effect on serum level TNF-α. Our study included 25 patients who had received oral zinc sulfate (10 mg/kg/day) maximum of 600 mg/kg/day, and 10 patients as control group who received a placebo in the form of Disflatyl® (Dimethicone) tablets.
The results showed that 3 patients had complete clearance, 6 had partial improvement and 16 had no response in the patients group. In the control group, all of the patients had shown no response.
All patients and controls had low normal serum zinc level before treatment. There was no significant difference between patients and controls or between responders and non-responders regarding serum level of TNF-α before treatment as well.
Zinc treated patients showed significant increase in levels of zinc and TNF-α after treatment than before treatment in comparison to control group. Responders showed significant increase in levels of zinc and TNF-α after treatment than before treatment in comparison to non-responders.