Efficacy and Safety of Oral Isotretinoin in Plane Warts: A Systematic Review on Clinical Studies Publisher



Abtahinaeini B ; Sattari H ; Rastegarnasab F ; Seyedyousefi S
Source: Scientifica Published:2025

Abstract

Background: Human papillomavirus–induced plane warts represent benign cutaneous lesions that, despite frequent spontaneous resolution, demonstrate persistence and recurrence patterns associated with considerable cosmetic and psychological morbidity. Isotretinoin has emerged as a therapeutic consideration for recalcitrant plane warts. We evaluated isotretinoin effectiveness and safety in the management of plane warts through a systematic analysis of available clinical evidence. Methods: We conducted this systematic review following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, with prospective registration in PROSPERO (ID: CRD420251060689). Comprehensive searches of PubMed, Scopus, and EMBASE databases were extended through November 2024. Primary efficacy outcomes focused on isotretinoin-induced changes in wart lesion characteristics. Results: Fifteen studies met the inclusion criteria, comprising six clinical trials, one cross-sectional study, six case reports, and two case series conducted across seven countries, encompassing 438 patients. Complete resolution rates demonstrated substantial variation, ranging from 38% to 87.5%. Among 10 studies documenting adverse events, cheilitis and dry skin emerged as the most common side effects. Conclusion: Oral isotretinoin shows promise for recalcitrant plane warts, but current evidence is heterogeneous and largely of moderate-to-low quality. These findings are insufficient to support routine clinical use at this time; well-designed, adequately powered randomized controlled trials with standardized dosing and outcomes are needed. © 2025 Elsevier B.V., All rights reserved.