An Exploratory Study of the Prevalence of Palmar and Plantar Warts in Patients with Inflammatory Bowel Disease

Background: In order to induce and maintain remission from their symptoms, inflammatory bowel disease (IBD) patients turn to immuno-modulating therapies. By decreasing cell mediated immunity, these patients are at increased risk of acquiring unwanted viruses such as human papillomavirus. The aim of this study was to investigate: prevalence of palmoplantar warts in IBD patients; association between wart and immuno-modulating therapies. Methods: Following ethical approval, 85 IBD patients consented to this single-centre, cross-sectional observational study. Participants completed a study specific survey followed by an examination of warts present. Prevalence of warts and numerous variables were analysed with chi square tests. Binary logistic regression analysis was used to predict the presence of warts. Results: Currently 19(22.4%) of the participants have warts. Participants using azathioprine are 6 times more likely to have palmar warts in comparison with other IBD medications. p=0.011, 95% CI [1.5, 24.9]. Crohns Disease participants are 5 times more likely to have palmar warts in comparison with ulcerative colitis patients. p=0.034, 95% CI [1.1, 26.4]. No significant association between use of biologic medications and warts was found. p=0.726. Conclusion: The data suggests prevalence of warts in IBD patients is increased, with a diagnosis of Crohns disease and the use of azathioprine being the largest predictors of the presence of the warts.