الفهرس 
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Abstract
Cutaneous warts are benign epidermal proliferation caused by a
DNA-containing human papillomavirus (HPV). To date, more than 100 types
of HPV have been identified and several others continue to be isolated.
In general, any epithelial surface can be affected, and there is a definite
association between the type of HPV and site of infection.
The treatment of patients with multiple, recalcitrant or recurrent warts continue to be a formidable task for both primary care physicians and dermatologists. Although warts are usually treated by a wide variety of methods including cryotherapy, surgical excision, podophyllin, bleomycin and various lasers, each mode of therapy has its own complications and failure rates.
Because wart proliferation is controlled by the immune system, manipulating the immune system to achieve a therapeutic response against HPV is an active field of investigation. Various methods have been used to stimulate the immunolgical response to HPV as oral levamisole, cimetidine, zinc sulfate, cidovir, intralesional interferons, topical DNCB, SADBE, imiquimod, intralesional immunotherapy with mumps, candida, trichophyton and tuberculin antigens and intradermal BCG vaccine. Topical immunotherapy, which involves the controlled induction of an allergic contact reaction in the wart itself, is one of the most potent ways to treat warts, and one of the least scarring forms of therapy. In this study we used lipid garlic extract (LGE) as topical immunotherapeutic agent in treating warts.
In present study, we aimed to evaluate the efficacy of LGE in treating non-venereal warts as well as its effect on serum level of TNF-α as an indicator to immunological response to it.
The present study included 50 patients divided them into two equal groups, treatment group and placebo group. 3 ml of venous blood were withdrawn from all patients before and after treatment to assay serum level of TNF-α.
Treatment of target warts in treatment group had achieved complete response in 21 (84%) patients while 4 (16%) patients showed no response after completing the treatment course. On the other hand, there was no response in all patients of placebo group.
In treatment group, Complete resolution of the distant untreated warts was observed in 10 (77%) patients while 3 (23%) patients showed no response after completing the treatment course. On the other hand, placebo group showed no response in all patients.
The response of warts to LGE showed statistically non significant difference in relation to the age, gender, site, size and type of wart while there was significant inverse relationship with the number.
No side effects were reported in any patients included in this study. Moreover, we observed no recurrence of warts during the follow-up observation period (3 months).
Wart regression was not associated with any statistically significant relationship with the serum level of TNF-α before and after completing treatment course in both groups.
In conclusion
In the present study, we found that LGE is highly effective in treating non-venereal warts regardless age, gender, site, size and type of them. It is available and cheap therapy.
Moreover, it is safe and achieves no recurrence. However, the serum level of TNF-α wasn’t affected by LGE. Therefore, the mechanism of how it exactly works to stimulate the immune system to cause clearance of warts is still unclear.