Association between serum zinc levels and multiple cutaneous warts: A cross-sectional study

Background: Warts are cutaneous manifestations of human papillomavirus (HPV). Trauma and maceration facilitate initial epidermal inoculation. The spread may then occur by autoinoculation. Local and systemic immune factors appear to influence the spread. Zinc is an essential micronutrient having a wide spectrum of actions. Deficiency of the same adversely affects the immune function, especially, T cell functions. The role of zinc as an immunological modulator activates lymphocytes and cytokines against the penetration and replication of viruses, which has increasingly been recognized. Numerous skin disorders have been linked to zinc deficiency. A high dose of oral zinc sulfate has shown outstanding therapeutic efficacy and prevents relapse in patients with recalcitrant and multiple warts. Owing to the therapeutic efficacy of oral zinc in the treatment of warts, the current study was undertaken to find out the association between serum zinc level and multiple cutaneous warts among the study population. Materials and methods: One hundred and ten patients with cutaneous warts met the inclusion criteria and an equal number of age and sex-matched controls were enrolled. A consecutive sampling technique was used for the enrolment. Details regarding the duration, number, clinical type, size, and distribution of the warts were recorded. Serum zinc levels were estimated in both cases and controls. Data were tabulated and analyzed using the SPSS software version 20. Results: The reference range for normal serum zinc levels was taken as 60-180 mu g/dL. Normal serum zinc levels were found in 91 (100%) of the cases and 100 (110%) of the controls; high levels were found only in 9 (10%) of the cases. Cases were found to have significantly higher mean serum zinc levels compared with the controls. (121.1 +/- 35.78 mu g/dL vs. 101.8 +/- 20.48 mu g/dL, P = 0.0001). Conclusion: Patients with multiple cutaneous warts were found to have higher mean serum zinc levels compared with age and sex-matched controls. There was no significant association of serum zinc levels with the duration or the number of warts.