Efficacy of oral zinc sulphate versus cryotherapy in the treatment of palmoplantar warts: a comparative interventional study

Abstract

Objective: To compare the efficacy and safety of oral zinc sulphate versus cryotherapy in the treatment of palmoplantar warts.

Method: The comparative, interventional study was conducted at the Dermatology Department of Pakistan Navy Station Shifa Hospital, Karachi, from December 1, 2024, to May 31, 2025, and comprised patients of either gender aged 18-50 years presenting with clinically diagnosed palmoplantar warts. The patients were divided into Group A receiving oral zinc sulphate 10mg/kg/day for 8 weeks, and Group B undergoing cryotherapy every 2 weeks for up to 4 sessions. Outcomes included complete clearance, recurrence and adverse effects. Data was analysed using SPSS 26.

Results: Of the 60 patients, 30 (50%) were allocated to each treatment group. The mean age was 32.7±8.1 years in Group A and 33.4±7.8 years in Group B. Males constituted 17 (56.7%) patients in Group A and 16 (53.3%) in Group B, while females constituted 13 (43.3%) and 14 (46.7%), respectively. The baseline demographic and clinical characteristics were comparable between the two groups, with no statistically significant intergroup differences. Complete clearance was observed in 23 (76.6%) patients in Group A, followed by partial response in 6 (20.0%) and no response in 1 (3.3%). The corresponding values in Group B were 20 (66.6%), 7 (23.3%) and 3 (10.0%), respectively. Recurrence was significantly lower in Group A, 1 (4.3%), compared to Group B, 4 (20%) (p=0.04). Gastrointestinal adverse effects occurred in 4 (13.3%) patients in Group A, while pain in 19 (63.3%) and blistering in 11 (36.6%) were reported in Group B.

Conclusion: Oral zinc sulphate demonstrated comparable efficacy to cryotherapy in achieving complete clearance of palmoplantar warts.

Key Words: Palmoplantar warts, Zinc sulphate, Cryotherapy, HPV, Immunotherapy, Comparative treatment.