Should I See a Dermatologist for Warts?

Warts are a type of skin surface neoplasm caused by the human papilloma virus. More common in children and young people, the incubation period is 1 to 3 months, and can spread by itself. The virus exists in the spinous layer cells, which can promote cell proliferation and wart-like damage. According to clinical manifestations and locations, they are divided into common warts, flat warts, plantar warts, genital warts (condyloma acuminatum), oral warts, throat warts, and verrucous epidermal dysplasia.

Basic Information

English name

warts

Visiting department

dermatology

Multiple groups

Children, youth

Common causes

Caused by human papillomavirus infection

Common symptoms

Increasing papules, mostly round, rough and thorny

Contagious

Some warts are contagious

Causes of warts

Warts are caused by human papilloma virus infection. It can be transmitted through direct or indirect contact. Most perianal and genital warts are transmitted through sexual contact. Trauma or skin damage is an important factor in HPV infection. The course of warts has an important relationship with the body's immunity. The incidence of warts is increased in patients with immunodeficiency such as kidney transplantation, malignant lymphoma, chronic lymphocytic leukemia and lupus erythematosus. However, the long-term mechanism of warts in relatively healthy populations is unclear.

Clinical manifestations of warts

Common wart

Traditional Chinese medicine calls it "Severe Sore", commonly known as "Stinging Sting", "Zongzi" and so on. The common wart begins as a pinpoint papules, gradually increases to peas larger or larger, round or polygonal, rough surface with thorn-like, hard, gray-yellow, stained yellow or stained brown, continued to develop as a papillary proliferation. Easy to bleed when rubbing or hitting. There is often one initial outbreak, which is constant or increasing for a long time, and neighbors merge with each other, and sometimes they can vaccinate themselves.

Occurs in adolescents, usually without symptoms, and occasional tenderness. Common warts can occur in any part of the body, and are common in fingers, back of hands, and feet. The course of the disease is chronic, and about 65% of common warts can resolve naturally within 2 years.

Special types include: Filamentous warts are common in the eyelids, neck, and crotch. Normal skin color or brownish gray. Generally without symptoms. Finger warts A cluster of uneven finger-shaped protrusions occurs on the same soft base, the tip of which is keratinous substance. The number varies, and often occurs on the scalp, but also on the toes and face. Generally without symptoms.

Plantar wart

For common warts that occur on the soles of the feet, trauma and friction are the causes, and there is a certain relationship between sweating on the feet. It started as a small, shiny pimples, then gradually increased, the surface keratinized, rough, gray-brown, gray-yellow or dirty gray, round, clear, surrounded by slightly thickened horny rings. Occurs under pressure on the heel, metatarsal head, or between the toes. Conscious pain at different levels, chronic course, can subside naturally. It is generally believed that children are easier to subside than adults, and those who are sweaty or have abnormal metatarsals are not likely to subside.

Common warts occur in the palms and are called palm warts. The clinical manifestations are similar to plantar warts.

3. Flat warts

The main violations are adolescents, which occur suddenly. Most of them are pimples with rice grains as large as mung beans, flat, hard, light brown or normal skin color, round, oval or polygonal, many in number, most dense, occasionally Arranged in stripes along the scratch (isomorphic reaction). Generally without conscious symptoms, occasionally slight itching. Occurs on the face, back of hands, and forearms. The course of the disease is chronic, sometimes suddenly disappears on its own, and it can last for many years without scarring.

4. Perianal genital warts (condyloma acuminatum).

Differential diagnosis of warts

According to the clinical manifestations, predisposition sites, and development of various warts, combined with pathological examination, the diagnosis is not difficult. Differential diagnosis:

1. Common warts and verrucous skin tuberculosis

The latter is an irregular wart-like plaque with redness around it. Positive tuberculosis-related tests can help identify.

2. Identification of plantar warts and corns

The translucent, yellow-white core is visible in the corns, and the tenderness is obvious and the surface is smooth.

3. Identification of flat warts and syringoma

The latter occurs in the vicinity of the eyelids and is generally close to the skin in color and completely different in histology.

4. Identification of plantar warts and spotted palmar plantar keratosis

The latter has an early onset, often with a family history, damage to the palms and soles, and scattered in the area under pressure.

Wart treatment

Most patients with warts subside on their own within 1 to 2 years of onset. Many patients have relapsed even when using a deeply destructive method, and 1/3 of the warts still recur. Therefore, it is necessary to choose carefully. Some therapies that can cause permanent scars are not suitable.

Drug treatment

(1) Fluorouracil ointment;

(2) intralesional injection of bleomycin;

(3) 0.7% cantharidin;

(4) 0.1% to 0.3% retinoic acid alcohol solution;

(5) 3% phthaloethylamine ointment or 3% phthaloethylamine dimethyl sulfoxide tincture;

(6) 0.5% podophyllotoxin;

(7) 5% imiquimod cream;

(8) Antiviral drugs;

(9) Others have been reported, such as salicylic acid and procaine. Interferon, transfer factor, thymosin and other immune enhancers, systemic or wart injection.

2. Photodynamic therapy

Systemic or topical photosensitizers, which cause local cell death after light exposure, can treat some common warts and genital warts.

3. physical therapy

Cryotherapy, electrocautery, laser therapy, and infrared coagulation therapy are suitable for a small number of common warts and plantar warts.

4 Surgery

Individual giant warts can be surgically removed.