الفهرس 
Introduction
WartsOnly 14 pages are availabe for public view
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Abstract
A wart is a small, rough growth resembling a cauliflower. It is the most common clinical manifestations of HPV infection.
Dermoscopy is a non-invasive method that allows evaluation of colors and microstructures of the epidermis, the dermoepidermal junction, and the papillary dermis not visible to the naked eye this enhancing the diagnostic accuracy.
The diagnosis of warts is made by direct clinical examination which requires trained personnel. Dermoscopy is a simple, fast and non-invasive diagnostic tool that is primarily used for pigmented lesions, but it has been increasingly used for many skin diseases including non pigmented tumors, hair and nail diseases, infectious and parasitic diseases.
A variety of interventions are available for treatment of warts. Vitamin D controls cell proliferation and differentiation and has immunoregulatory activities. Its effects are mediated via the vitamin D receptor (VDR), which is present in keratinocytes, melanocytes, fibroblasts, and immune system cells of the skin.
The aim of the study is to evaluate the efficacy and safety of intra lesional vitamin D3 injection in palmoplantar and periungual warts in comparison to placebo control group.
The present study included 62 patients (32 patients injected by vitamin D3 and 30 patients injected by saline) that were divided in to 3 groups clinically diagnosed as palmar, plantar and periungual warts. All patients were subjected to clinical and dermoscopic examinations before, during and after treatment.
The results of injection in vitamin D3 group showed 43 warts (out of 72 warts) with complete clearance, 6 warts with partial improvement and 23 warts with no response. While in the control group, results recorded to be nil.
The present study has found that response of warts treatment with vitamin D3 differ according to their site with 100% improvment in periungual warts.
With dermoscopy, warts display “multiple densely packed papilla, each containing a central red or black dot or loop, which is surrounded by a whitish halo”. The red dots and loops and the black dots and loops represent normal and thrombosed capillaries, respectively. So, dermoscopy can be considered as important tool in diagnosis, follow up during and after treatment of warts.
It can be concluded that the present study confirm the efficacy and safety of intralesional vitamin D3 injection in palmoplantar and periungual warts.