Abstract
INTRODUCTION Some viral warts are refractory to treatment, some others tend to recur. Oral isotretinoin is useful against warts to varying degrees. OBJECTIVE To determine the efficacy of oral isotretinoin for treating mucocutaneous human papillomavirus infections. METHODS A systematic review and meta-analysis of studies published from the date of inception of the databases to December 30, 2017 were conducted. Randomized controlled trials or case series with ≥10 patients with mucocutaneous human papillomavirus infection who had received oral isotretinoin treatment were analyzed. The meta-analysis estimated the pooled odds ratio and pooled response rate. RESULTS The review included eight studies. Trials of oral isotretinoin versus placebo treatment revealed that isotretinoin effectively treated mucocutaneous human papillomavirus infections (odds ratio: 43.8, 95% confidence interval: 9.7-198.8). The pooled estimate of the complete response rate of oral isotretinoin to mucocutaneous human papillomavirus was 67.7% (95% confidence interval: 49.5-81.7%). Another pooled estimation revealed that 83.9% (95% confidence interval: 59.7-94.9%) of patients exhibited at least 50% lesion clearance, whereas 12.3% with complete response experienced recurrence. LIMITATIONS This meta-analysis had a small sample size and high inter-study heterogeneity. CONCLUSION Oral isotretinoin is superior to placebo for treating mucocutaneous human papillomavirus infections, particularly plane warts. The recurrence rate and risk of severe side effects are low.
