Wart

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For the Nintendo character, see Wart (Nintendo). For toad warts, see parotoid gland.
Warts
Classification and external resources
Warts on the big toe
ICD-10 B07.
ICD-9 078.1
DiseasesDB 28410
MedlinePlus 000885
eMedicine emerg/641 
MeSH D014860
A filiform wart on the eyelid.
A filiform wart on the eyelid.

A wart is generally a small, rough tumor, typically on hands and feet, that can resemble a cauliflower or a solid blister. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV) and are contagious when in contact with the skin of another. It is also possible to get warts from using towels or other objects. They typically disappear after a few months but can last for years and can recur.

Contents

[edit] Types of wart

A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved.[1] These include:

  • common wart (Verruca vulgaris): a raised wart with roughened surface, most common on hands and knees
  • flat wart (Verruca plana): a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees
  • filiform or digitate wart: a thread- or finger-like wart, most common on the face, especially near the eyelids and lips
  • plantar wart (verruca, Verruca pedis): a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet
  • mosaic wart: a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet
  • genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata): a wart that occurs on the genitalia.

[edit] Treatment

[edit] Prescription

Two viral warts on a middle finger, being treated with a mixture of acids (like salicylic acid) to remove them. A white precipitate forms on the area where the product was applied.
Two viral warts on a middle finger, being treated with a mixture of acids (like salicylic acid) to remove them. A white precipitate forms on the area where the product was applied.

Treatments that may be prescribed by a medical professional include:

  • Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers ("immunomodulators"), or formaldehyde.
  • Cryosurgery, which involves freezing the wart (generally with liquid nitrogen), creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin falls off by itself.
  • Surgical curettage of the wart.
  • Laser treatment.
  • Imiquimod, a topical cream that helps the body's immune system fight the wart virus by encouraging interferon production.
  • Candida injections at the site of the wart, which also stimulate the body's immune system.[2]
  • Cantharidin, a chemical found naturally in many members of the beetle family Meloidae which causes dermal blistering.

The wart often regrows after the skin has healed.

One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75% observed with salicylic acid compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants.[3] The reviewers also concluded that there was little evidence of a significant benefit of Cryotherapy over placebo or no treatment.[3]

[edit] Over-the-counter

There are several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid or a bottle of concentrated salicylic acid solution. Removing a wart with salicylic acid requires a strict regimen of cleaning the area, applying the acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a wart.

Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing.

[edit] Duct tape occlusion therapy

Main article: Duct tape occlusion therapy

Duct tape occlusion therapy (DTOT) involves placing a piece of duct tape over the wart(s) for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. Evidence suggests that DTOT is more effective than cryotherapy,[4] though the use of duct tape and moleskin is no more effective than moleskin alone.[5]

[edit] See also

Look up Wart in
Wiktionary, the free dictionary.

[edit] References

  1. ^ Mosby's Medical, Nursing, & Allied Health Dictionary (5th edn), Anderson KN, Anderson LE, Glanze WD, eds, Mosby
  2. ^ Horn TD, Johnson SM, Helm RM, Roberson PK (2005) Intralesional immunotherapy of warts with mumps, Candida, and Trichophyton skin test antigens. Arch Dermatol 141: 589–94
  3. ^ a b Gibbs S, Harvey I, Sterling JC, Stark R. (2003) Local treatments for cutaneous warts. Cochrane Database of Systematic Reviews Issue 3
  4. ^ Focht DR, Spicer C, Fairchok MP (October 2002). "The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart)". Arch Pediatr Adolesc Med 156 (10): 971–4. PMID 12361440.  lay-summary
  5. ^ Wenner R, Askari SK, Cham PM, Kedrowski DA, Liu A, Warshaw EM (March 2007). "Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial". Arch Dermatol 143 (3): 309–13. doi:10.1001/archderm.143.3.309. PMID 17372095. 

[edit] External links