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Comparative evaluation of therapeutic efficacy and safety of 40% hydrogen peroxide versus 80% of trichloroacetic acid in genital warts

Narvinderjeet Kaur, Amarbir Singh Boparai, Sumir Kumar, Balvinder Kaur Brar, Rubeena Bano, Onkar Singh.


Background: Warts are a common manifestation of infection due to HPV, prevalence more common in developing world. No modality is 100% efficacious in the management of warts. Topical therapy is more preferred method by majority of patients. Trichloroacetic acid (TCA) solution is well established modality in treatment of genital warts. Hydrogen peroxide used in higher concentrations is a good cautery agent.

Aim and Objectives: The study was conducted to evaluate and compare the therapeutic efficacy and safety of 40% hydrogen peroxide solution and 80% TCA solution in genital warts.

Materials and Methods: Topical 40% hydrogen peroxide and 80% TCA were used in Group A (20 patients) and Group B (20 patients), respectively, for three sittings at 2 weeks interval.

Results: About 65% of the patients in TCA and 55% patients in H2O2 group had significant improvement (Grade 4 and Grade 3) (P = 0.311). Descriptive statistical methods and 2-Chi-square relation were used for analyzing data with Statistical Package for the Social Sciences (SPSS) 21 (SPSS Inc., Chicago, IL, USA). Results: About 40% H2O2 and 80% TCA, both are cost-effective and easy to use modalities with 40% H2O2 having better safety profile as compared to 80% TCA. H2O2 group showed decrease in size of lesions 63.33% versus and TCA group 70% (p value 0.311) with 10% of TCA group patients having ulcer formation versus none of the patients having significant adverse effect in H2O2 group.

Conclusion: We found both the modalities to be safe and effective. However, we recommend further studies should be carried out to assess the safety and efficacy with bigger sample size and control arms for both the groups topical 40% hydrogen peroxide solution and topical 80% TCA solution.

Key words: Genital Warts; Hydrogen Peroxide; Trichloroacetic Acid

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