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Information on Warts

Warts (also called verrucae) are common, benign infections of the skin and adjacent mucous membranes. Although warts may occur at any age, common warts (verrucae vulgaris) are most prevalent in children and young adults. Flat warts usually occur in children but can also affect adults. Genital warts may be transmitted through sexual contact; however, they're not always venereal in origin.

Warts are particularly common in childhood and are spread by direct contact or autoinocculation. This means if a wart is scratched, the viral particles may be spread to another area of skin. It may take as long as twelve months for the wart to first appear.

Types of warts include:

  • flat warts
  • common warts
  • plantar warts
  • filiform warts

Causes

Warts are caused by infection with the human papillomavirus, a group of ether-resistant, deoxyribonucleic acid-containing papovaviruses. The mode of transmission is probably through direct contact, but autoinoculation is possible.

Signs and symptoms

  • Small, fleshy, grainy bumps
  • Flesh-colored, white, pink or tan
  • Rough, round, or oval lesions on soles of feet -- flat to slightly raised -- painful to pressure
  • Rough to the touch

Warts may occur singly or in multiples. They often contain one or more tiny black dots, which are sometimes called wart seeds but are actually small, clotted blood vessels. Common warts are usually painless. Young adults and children appear to be affected most often.

Diagnostic tests

Visual examination usually confirms the diagnosis. Recurrent anal warts require sigmoidoscopy to rule out internal involvement, which may necessitate surgery. To distinguish plantar warts from corns and calluses, gently shave down the lesion with a scalpel; plantar warts exhibit red or black capillary dots.

Treatment

Effective treatment varies with the location, size, and number of warts. It also depends on the patient's age, pain level (current and projected), history of therapy, and compliance with treatment. Most people develop an immune response that causes warts to disappear spontaneously and require no treatment.

Treatment may include:

  • electrodesiccation and curettage. High-frequency electric current destroys the wart and is followed by surgical removal of dead tissue at the base. After application of an antibiotic ointment, the area is covered with a bandage for 48 hours.
  • cryotherapy. Liquid nitrogen kills the wart; the resulting dried blister is peeled off several days later. If initial treatment isn't successful, it can be repeated at 2- to 4-week intervals. This method is useful for either periungual warts or for common warts on the face, extremities, penis, vagina, or anus.
  • acid therapy (primary or adjunctive). The patient applies acid-impregnated plaster patches (such as 40% salicylic acid plasters) or acid drops (such as 5% to 20% salicylic and lactic acid in flexible collodion [Duofilm]) every 12 to 24 hours for 2 to 4 weeks. This method isn't recommended for areas in which perspiration is heavy or that are likely to get wet or for exposed body parts on which patches are cosmetically undesirable.
  • 25% podophyllum resin in compound with tincture of benzoin (for venereal warts). The podophyllum solution is applied on moist warts. The patient must lie still while it dries, leave it on for 4 hours, and then wash it off with soap and water. The treatment may be repeated every 3 to 4 days and, in some cases, must be left on a maximum of 24 hours, depending on the patient's tolerance. The use of this drug is contraindicated in pregnant patients.

The use of antiviral drugs is under investigation. Suggestion and hypnosis are occasionally successful, especially with children. Carbon dioxide laser treatment has successfully been used to remove all types of warts.

Prevention
  • Avoid direct skin contact with a wart on someone else.
  • After filing your wart, wash the file carefully since you can spread the virus to other parts of your body.
  • After touching any of your warts, wash your hands carefully.

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