• Ushna Ashraf, Najia Ahmed, Moizza Tahir, Fatima Hasan, Abid Hussain Shah, and Omer Farooq.
• Department of Dermatology, PNS Shifa Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2023 Jan 1; 33 (1): 161916-19.

ObjectiveTo determine the effectiveness of autoinoculation in patients with multiple skin warts.Study DesignA Quasi-experimental study.Place And Duration Of StudyDermatology department of PNS Shifa Hospital, from April to October 2021.MethodologyNinety-six patients with multiple warts were enrolled in this study after informed consent. Under strict aseptic measures and local anaesthesia, wart tissue was removed and crushed on a glass slide with the scalpel. Autoinoculation was done on flexor aspects of bilateral forearms after making a subcutaneous pocket which was then stitched. Patients were assessed at monthly intervals for 03 months and after 01 month of the last autoinoculation to see sustained response. Effectiveness was recorded according to ordinal scale; worsening of lesions/no response at <50% resolution/partial response at >50%- <100% resolution and complete response at 100% resolution.ResultsComplete response was observed in 88 (91.66%) of the cases, no response was observed in 2 (2.1%) cases where as 6 (6.3%) showed worsening. All patients were compliant with the follow-up. No new eruptions were observed.ConclusionAutoinoculation is a minimally invasive and cost-effective procedure with excellent response to wart. It also decreases recurrence by generating viral-specific immunity.Key WordsViral warts, Autoinoculation, Multiple, Immunotherapy, Verrucous, Treatment, HPV, Resistant.

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