Evaluation of Topical Hydrogen Peroxide 30% versus Topical Zinc Sulphate 10% in Treatment of Plane Warts: Clinical and Dermoscopic Study

Abstract

Background: Plane warts are caused by infection with human papilloma virus (HPV). Lesion usually presented as 2-4 mm flat topped papules, which are slightly erythematous or brown on pale skin and hypopigmented on darker skin. Many modalities of treatment were used, but none is uniformly effective. Objectives: To assess the efficacy and safety of topical hydrogen peroxide (HP) 30% versus topical zinc sulphate (ZnSO4) 10% in plane warts treatment. Patients and Methods: This is a parallel-group clinical study conducted on 64 patients divided into two groups; H2O2 group (n=32) and ZnSO4 group (n=32). Patients were evaluated clinically and by the dermoscope at the end of two, four and six weeks. Results: H2O2 group showed complete response (CR) in 81.3% of cases, while zinc sulphate group revealed CR in 34.4% of cases. There was a statistically significant higher proportion of “disappearance of dotted vessels and reddish gray / pale background plus appearance of normal skin markings” in H2O2 group vs. zinc sulphate group. There was a statistically significantly higher ratio of CR among those with facial lesions who received treatment by hydrogen peroxide. Conclusion: In the context of plane warts, hydrogen peroxide (30%) seemed to be an effective therapeutic modality with a higher satisfaction rate compared to 10% ZnSO4 with minimal complications.