Warts
Muna Hassan
Tasneem Hassoun
what are the warts ?
• A wart is a benign skin growth caused by some
types of the virus called the human
papillomavirus (HPV). there are over 100 HPV
subtypes.
• warts can grow anywhere on the body.
• they are most common among children and
young adults.
How is it form?
• HPV infects the top layer of skin, usually
entering the body in an area of broken skin.
The virus causes the top layer of skin to grow
rapidly forming warts.
Types
• there are seven kinds of warts: " they look
different and form on different part of the body“
1.Common warts
2.Filiform warts
3.Flat warts
4.Palmar and plantar warts
5.Mosaic warts
6.Periungual warts
7.Genital warts.
1.Common warts
• Common warts: Common warts are caused by
HPV. They are usually asymptomatic but
sometimes cause mild pain when they are
located on a weight-bearing surface (eg, bottom
of the feet).
• Common warts are sharply demarcated, rough,
round or irregular, firm, and light gray yellow
nodules .
• They appear most often on sites subject to
trauma (eg, fingers, elbows, knees, face) but may
spread elsewhere.
Common warts
2.Filiform warts
• Filiform warts: These warts are long, narrow,
frondlike growths, usually located on the
eyelids, face, neck, or lips.
• They are usually asymptomatic. This
morphologically distinct variant of the
common wart is benign and easy to treat.
Filiform warts
3.Flat warts
• Flat warts: Flat warts caused by HPV.they are
smooth, flat-topped, yellow-brown, pink, or
flesh-colored papules, most often located on
the face and along scratch marks; they are
more common among children and young
adults.
• They generally cause no symptoms but are
usually difficult to treat.
Flat warts
4.Palmar and plantar warts
• Palmar and plantar warts: These warts, caused
by HPV type 1, occur on the palms and soles;
they are flattened by pressure and surrounded
by cornified epithelium.
• They are often tender and can make walking
and standing uncomfortable.
• They can be distinguished from corns and
calluses by their tendency to pinpoint
bleeding when the surface is pared away.
Palmar and plantar warts
5.Mosaic warts
• .Mosaic warts: Mosaic warts are plaques
formed by the coalescence of myriad smaller,
closely set plantar warts. As with other plantar
warts, they are often tender.
Mosaic warts
6.Periungual warts
• Periungual warts: These warts appear as
thickened and fissured around the nail plate.
They are usually asymptomatic, but the
fissures cause pain as the warts enlarge.
• Periungual warts are more common among
patients who bite their nails.
Periungual warts
7.Genital warts
• Genital warts: Genital warts (Sexually Transmitted
Diseases (STDs)manifest as discrete flat to broadbased smooth papules on the perineal, perirectal,
labial, and penile areas.
• Infection with high-risk HPV types (most notably
types 16 and 18) is the main cause of cervical
anal cancer. These warts are usually
asymptomatic.
• Perirectal warts sometimes itch.
How can it spread?
• warts are easly spread by direct contact with a
human papiloma virus.
• pepeole can infect them self again by
touching the wart and then another part of
their body.
• you can infect another person by sharing
towels or other personal items.
Cont…
• immune factors appear to influence spread.
immunosuppressed patients(esp those with
HIV infection or kidney transplantation are at
risk of developing generalized lesions that are
difficult to treat.
• It is unlikely that you will get a wart every time
you come in contact with HPV.
• Some people are more likely to get warts than
others
Diagnosis
1.Clinical evaluation
2.Rarely biopsy
Diagnosis
• Diagnosis is based on clinical appearance;
biopsy is rarely needed.
• A cardinal sign of warts is the presence of
pinpoint black dots (thrombosed capillaries)
or bleeding when warts are shaved.
• If necessary, confirm the diagnosis of a wart
by shaving its surface to reveal thrombosed
capillaries in the form of black dots.
Prognosis
• Many warts regress spontaneously
(particularly common warts); others persist for
years and recur at the same or different sites,
even with treatment. Factors influencing
recurrence appear to be related to the
patient's overall immune status as well as local
factors.
Prognosis
• Genital HPV infection has malignant potential
(cervical and anal cancer), but malignant
transformation is rare in HPV-induced skin
warts, except among immunosuppressed
patients.
How to differentiate between
corns,calluses, and plantar warts?
• a corn may be differentiated from a plantar
wart or calluses by paring away the thickened
skin. After paring, a callus shows smooth
translucent skin, where a wart appears sharply
circumscribed, sometimes withsoft macerated
tissue or with central black dots (bleeding
point). while a core, when pared, shows a
sharply outlined yellowish to transluscent
core.
How are they treated?
• Most warts don't need treatment. But if you
have warts that are painful or spreading, or if
you are bothered by the way they look, your
treatment choices include:
1.Using a home treatment such as salicylic acid .
You can get these without a prescription.
2.Putting a stronger medicine on the wart, or
getting a shot of medicine (antiviral acyclovir)in
it.
Cont…
3. Freezing the wart (cryotherapy). The most
common agent is liquid nitrogen.
Mixture of dimethyl ether &propane(DMEP)
4. Removing the wart with surgery
(electrosurgery, laser surgery).
Cont…
• Wart treatment does not always work. Even
after a wart shrinks or goes away, warts may
come back or spread to other parts of the
body. This is because most treatments destroy
the wart but do not kill the virus that causes
the wart.
• Up to 30% of warts disappear by themselves
within 6 months, and most will disappear
without any treatment within 3 years.