Warts are benign skin growths caused by human papillomavirus (HPV) infection. There are several types of warts that vary in appearance and location on the body, including common warts, plantar warts, flat warts, genital warts, and periungual warts. Warts are typically diagnosed through visual examination and rarely require a biopsy for confirmation. Treatment options include topical creams or destructive methods like cryotherapy. While many warts resolve on their own, others can persist for years or recur despite treatment.
2. INTRODUCTION
• Warts are common, benign, epidermal lesions caused by human
papillomavirus infection.
• They can appear anywhere on the body in a variety of
morphologies.
3. • Caused by HPV (Human Papilloma Virus) infection.
• Spreads by autoinnoculation, facilitated by trauma.
• Immunocompromised patients are at risk.
ETIOLOGY
5. • Caused by HPV types 1, 2, 4, and 7
• Usually asymptomatic but sometimes cause mild pain when they
are located on a weight-bearing surface
• Sharply demarcated, rough, round or irregular, firm, and light
gray, yellow, brown, or gray-black nodules 2 to 10 mm in
diameter.
• Sites: Subject to trauma (eg, fingers, elbows, knees, face)
COMMON WARTS (Verrucae Vulgaris)
6. • These warts are long, narrow, frondlike growths, usually located
on the eyelids, face, neck, or lips.
• Usually asymptomatic.
• This morphologically distinct variant of the common wart is
benign and easy to treat.
FILIFORM WARTS
7. • Caused by HPV types 3 and 10 and occasionally 26 to 29 and
41.
• Smooth, flat-topped, yellow-brown, pink, or flesh-colored
papules, most often located on the face and along scratch marks
• More common among children and young adults and develop by
autoinoculation.
FLAT WARTS
8. • Caused by HPV types 1, 2, and 4
• Occur on the palms and soles
• Flattened by pressure. Tender and can make walking and
standing uncomfortable.
• Distinguished from corns and calluses by their tendency to
pinpoint bleeding when the surface is pared away.
PALMAR AND PLANTAR WARTS
9. • Plaques formed by the coalescence of myriad smaller, closely
set plantar warts.
• As with other plantar warts, they are often tender.
MOSAIC WARTS
10. • Appear as thickened, fissured, cauliflower-like skin around the
nail plate.
• Usually asymptomatic, but the fissures cause pain as the warts
enlarge. Patients frequently lose the cuticle and are susceptible
to paronychia.
• More common among patients who bite their nails or who have
occupations where their hands are chronically wet such as
dishwashers and bartenders.
PERIUNGUAL WARTS
11. • Genital warts manifest as discrete flat to broad-based smooth to
velvety papules to rough and pedunculated excrescences on the
perineal, perirectal, labial, and penile areas.
• Infection with high-risk HPV types (most notably types 16 and 18
but also types 31, 33, 35, and 39) is the main cause of cervical
cancer.
• Usually asymptomatic. Perirectal warts often itch.
GENITAL WARTS
12. DIAGNOSIS
• CLINICAL EVALUATION
A cardinal sign of warts is the absence of skin lines crossing
their surface and the presence of pinpoint black dots
(thrombosed capillaries) or bleeding when warts are shaved.
• RARELY BIOPSY
15. • Many warts regress spontaneously (particularly common warts);
others persist for years and recur at the same or different sites, even
with treatment
• Genital HPV infection has malignant potential, but malignant
transformation is rare in HPV-induced skin warts, except among
immunosuppressed patients.
PROGNOSIS
