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Triple intralesional antigen immunotherapy is an experimental combination biologic treatment developed by researchers at Zagazig University for the management of recalcitrant extragenital warts. The therapy involves the intralesional injection of three distinct antigens: purified protein derivative (PPD), Candida antigen, and the measles-mumps-rubella (MMR) vaccine. The mechanism of action relies on inducing a localized delayed-type hypersensitivity reaction at the site of the largest wart, which triggers a systemic cell-mediated immune response. This immune activation facilitates the recognition and destruction of human papillomavirus (HPV) infected cells, leading to the clearance of both treated and distant warts. Clinical trials have demonstrated that this triple-antigen approach is significantly more effective than using any of the antigens individually, particularly in patients with warts that have failed multiple prior therapeutic modalities.
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