Warts or verruca vulgaris is a common skin condition of both children and adults. Warts are caused by a virus, called human papilloma virus, also known as HPV. There are more than 100 types of HPV viral strains. Different strains cause different types of warts. This virus is contagious and can be transferred through skin to skin contact.
Infection with HPV can be clinical, meaning obvious to the naked eye, subclinical, meaning they are visible with the use of chemicals such as acetic acid soaking or latent, which describes virus present in normal appearing skin.
Warts can occur anywhere on the body, but are most common on one’s hands and feet. They are generally small growths that resemble cauliflowers, you may even notice tiny dots on their surface. Warts on the soles of the feet are known as plantar warts. These tend to grow inward from the pressure of walking and standing and are often painful. These growths are benign and do not become cancerous. The peak age for the development of a wart is in the teenage and early adult years.
Warts that are sexually acquired are known as genital warts. These are often acquired from latent infection. In some populations, the rate of infection can exceed 50%. While the strains of this virus that cause genital warts are usually benign, meaning they have a low chance of becoming cancerous , it is important to be followed by a medical professional, as there are HPV strains linked to cancer of the cervix, penis, and mouth.
Diagnosis of a wart can be made clinically, if it is clinically apparent. When there is ambiguity, your dermatologist can perform a skin biopsy, to confirm the diagnosis. Malignant melanoma, a deadly skin cancer, when found on the bottom of the foot, can be mistaken for a wart.
Treatment of warts can be very frustrating for patient and physician alike. They can be a source of embarrassment and social isolation. Treatment can be ineffective, painful and need to be continuously repeated. Warts on the fingers can grow to involve the proximal nail fold, invade below the nail plate, leading to its destruction and permanent deformity. Warts spread by autoinoculation or spreading from touching other parts of the body. Nail biters can develop warts on their lips or tongue. Patients with atopic eczema can have warts spread diffusely due to a defect in their immune system and scratching the skin due to extreme itch.The natural history of warts is that they spontaneously resolve. When and if this happens can be problematic, since they can be spread to other body parts and to other people, making treatment essential to eradicate or curtail their spread.
Treatment of warts can vary based on the type of wart being treated, the number involved, the location of the body, the skin type of the patient, the age of the patient and previous treatments used. There are various treatment options, including applying topical chemicals, freezing with liquid nitrogen, laser therapy, electrodessication, and surgical excision. The method utilized, can be determined by your dermatologist, who can determine the best treatment option for you.
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