Citric acid 50% solution versus tretinoin 0.05% lotion in the treatment of plane warts

Background: the course of human papilloma virus infection varies considerably and there are many modalities of therapy, reflecting that none is uniformly effective. objective: to evaluate and compare the efficacy of 50% citric acid solution in water versus 0.05% tretinoin lotion for the treatment of plane wart in a sample of egyptian patients. patients and methods: ninety patients with plane warts were included in this randomized comparative therapeutic study with age range from 7 to 34 years. the selected patients were divided into two treatment groups, wherein group i applied 50% citric acid solution twice daily and group ii applied 0.05% tretinoin lotion once daily for 8 weeks or till complete clearance. the follow-up time was 3 weeks after the final treatment. results: there was a statistically significant difference (p<0.001) between the number of lesions before and after treatment in both groups. the duration of treatment was longer in group i with better results in patients above the age of 20 years (p<0.001) and in warts located on the dorsum of the hand (p<0.05) compared with group ii, with less burning sensation and better results in younger patients. conclusion: fifty percent citric acid solution appears to be a promising self-treatment option from the perspective of both cost and effectiveness in comparison with the efficacy of 0.05% tretinoin lotion in treating plane warts.