ArticleInternational medical case reports journal2026
Resistant Facial Verruca Plana Treated with a Single-Dose Intramuscular Hepatitis B Vaccine as Immunotherapy in a Child.
Article in International medical case reports journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Facial Verruca plana is a common manifestation of human papillomavirus infection that frequently affects the face of children and adolescents and may be resistant to conventional therapies. Management is particularly challenging in pediatric patients due to lesion persistence, recurrence, and cosmetic concerns that limit the use of destructive modalities. Immunotherapy has emerged as a promising alternative; however, evidence for its use in facial verruca plana remains limited. Case Presentation: A 9-year-old girl presented with a more than two-year history of multiple facial verruca plana refractory to standard treatments, including topical tretinoin, salicylic acid, and imiquimod. She had no underlying systemic or immunological disease. Clinical examination revealed numerous flat-topped, skin-colored to slightly erythematous papules diffusely involving the face. Laboratory investigations were unremarkable. Following pediatric consultation and informed consent, a single intramuscular hepatitis B vaccine booster was administered as an off-label immunotherapeutic intervention. Clinical improvement was observed within three weeks, with complete resolution of all lesions by six weeks. No adverse effects were reported, and no recurrence was observed during 10 months of follow-up, with sustained remission at 18 months. Discussion: Immunotherapeutic approaches promote wart clearance through enhancement of cell-mediated immunity. Previous studies of hepatitis B vaccine immunotherapy have largely focused on common and plantar warts and often required repeated or intralesional administration. In contrast, this case demonstrates complete and sustained resolution of facial verruca plana in a pediatric patient following a single intramuscular dose, suggesting a systemic immunomodulatory effect. Conclusion: Intramuscular hepatitis B vaccination may represent a safe and effective immunotherapeutic option for selected pediatric patients with recalcitrant facial verruca plana. Further controlled studies are required to confirm its efficacy and clinical applicability.
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