Warts

What are Warts?

Warts are caused by the human papillomavirus (HPV). There are many types of warts however, the most common type is called the common wart (verruca vulgaris).  Warts are contagious and can be transmitted from person to person via areas of broken skin.  Common warts are usually raised, with a rough, cauliflower-like surface and most commonly affect the hands but can be present anywhere on the body.  Flats warts are skin-colored or reddish, smooth surfaced, slightly elevated and flat-topped papules most commonly located on the dorsal hands, arms or face. They range from 1-5 mm or more, and can range from a few lesions to hundreds that may become grouped or confluent. These lesions may become inflamed and regress spontaneously. Plantar warts begin as small shiny papules and progress to thick, deep papules on the soles and lateral aspects of the feet, with sloping sides and a central depression. On the feet, these are painful to pressure when walking due to deep inward growth. They are usually found on weight-bearing areas, such as the metatarsal head and heel. Plantar warts can also coalesce into large plaques.  Condylomas (genital warts) are caused by human papillomavirus (HPV) and are transmitted by sexual contact. Approximately two thirds of individuals who have sexual contact with an infected partner will develop genital warts. The exact incubation time is unknown but estimated to be 3 weeks to 8 months. The lesions are 1 to 3mm in diameter, discrete, sessile, smooth-surfaced warts that may be skin-colored, brown or whitish and are found on the external genitalia, perineum, perianally, or in adjacent areas such as the inguinal fold. They may also present as pedunculated or broad-based papillomas or as large confluent plaques that can extend into the vagina, urethra, or anal canal.  These lesions are generally not painful, but they can be associated with itching. Risk factors for developing genital warts include having unprotected sex with multiple partners, a history of a prior sexually transmitted infection, and engaging in sexual activity with a partner whose sexual history you don’t know.

Wart Removal/Treatment options include: no treatment, liquid nitrogen, electrodessication, multiple topical substances, intralesional injections and laser therapy.  Warts commonly recur which may necessitate the need for multiple treatments.

 

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