Viral warts

Viral warts are ubiquitous and harmless skin growths caused by human papillomavirus (HPV). It infects epidermal or mucosal cells creating a warty knoll lesion called verruca.

Diagnosis is clear-cut and based on clinical grounds, but in some cases uncertainty emerges. Facial warts can be mistaken for lichen nitidus, in such instances, histological differences confirm the diagnosis.

Common locations for warts include the hands and feet, but they manifest differently depending on the location. Palmar or hand warts appear as hyperkeratotic papules, whereas plantar or feet warts are exhibited as thick plaques. Both arise under pressure points and may cause pain.

Treatments are discounted due to the nature of warts; they resolve spontaneously and appear to be for the most part asymptomatic. If treatment is pursued, different modalities can be used to tackle it. The use of topical salicylic acid treatment, which is typically tolerated, works gently at exfoliating the skin from the epidermal layer, softening the skin, and encouraging cell turnover. Another modality, which the commonest, utilizes liquid nitrogen, formerly called “cryotherapy”, to directly destroy and induce secondary inflammation.

In general, cutaneous viral warts are uncommon, nonetheless, they do appear often in children, particularly schoolchildren and immunocompromised. Patients choose to excise warts for cosmetic reasons, pain, or discomfort, but they do not pose a health threat as they are benign, however, they are mischievously contagious and can be spread through contact.

Written by: Naif Alshaikh, Medical Student 

Resources:

https://dermnetnz.org/topics/viral-wart/

https://www.huidhuis.nl/sites/huidhuis.nl/files/inline-images/PDF/BMJ_cutaneous_viral_warts.pdf

https://www.yalemedicine.org/conditions/viral-warts/