Warts are common skin growths caused by the human papillomavirus (HPV). They can appear anywhere on the body but are most commonly found on the hands, feet, and genitals. They vary in appearance and can be bothersome but are generally harmless.
Causes
- Human Papillomavirus (HPV): Warts are primarily caused by different strains of HPV. The virus infects the top layer of skin, usually entering through an area of broken skin.
- Transmission: HPV is contagious and can be spread through direct contact with a wart or something that touched a wart, such as towels or surfaces. Genital warts are usually sexually transmitted.
Diagnosis
- Physical Examination: Most warts are diagnosed based on their appearance. Common warts have a rough surface and are rounded; plantar warts are found on the soles of the feet and may be flat and painful; flat warts are smaller and smoother.
- Medical History: Including duration, previous treatments, and any relevant family history.
- Biopsy: Rarely needed, but can be used to rule out other skin lesions, especially if a wart is atypical or does not respond to treatment.
Differential Diagnosis
- Corns and Calluses: Thickened skin due to friction, not viral.
- Molluscum Contagiosum: Caused by a poxvirus, these lesions are more dome-shaped and have a central dimple.
- Skin Cancer: Including squamous cell carcinoma, especially in adults with a new or changing skin lesion.
- Seborrheic Keratosis: Benign skin growths that are more common in older adults.
Management
- Observation: Many warts resolve spontaneously, especially in children, and may not require treatment unless they are bothersome.
- Salicylic Acid: Applied topically to peel away the wart.
- Cryotherapy: Freezing the wart with liquid nitrogen.
- Immunotherapy: Imiquimod cream
- Laser Therapy: Used for difficult-to-treat warts.
- Electrosurgery and Curettage: Burning and scraping off the wart.
Prevention
- Avoid Direct Contact: With warts, both on oneself and others.
- Keep Feet Dry and Clean: To prevent plantar warts.
- Use Barrier Protection: During sexual activity to reduce the risk of genital warts.
- Do Not Pick or Scratch Warts: To prevent spread.
- Vaccination: HPV vaccines can prevent certain types of warts, including genital warts.
Conclusion
Warts are typically harmless and often resolve without treatment. However, they can be bothersome, and their treatment depends on their location, number, and symptoms. Some warts, like genital warts, require specific medical attention due to their mode of transmission and association with certain types of HPV. In cases where warts are painful, persistent, or cosmetically unappealing, various treatment options are available.