Materiały źródłowe

• #1 Warts, verrucas, human papillomavirus infection

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

  Warts are particularly common in: […] Cutaneous viral warts are usually diagnosed clinically. Clinical clues to diagnosis can include: […] Dermoscopy assists visualisation of the papillary capillaries of a viral wart, and can distinguish other verrucous lesions such as a seborrhoeic keratosis. […] Skin biopsy is sometimes required when squamous cell carcinoma cannot be excluded clinically such as in an organ transplant recipient susceptible to both. […] Differential diagnoses for a cutaneous viral wart can include: […] Treatment may not be required in all cases as most warts resolve spontaneously especially in children. Indications for active treatment include: […] Treatments do not kill the virus, but work by removing virus-containing skin. […] No treatment is universally effective at eradicating viral warts.

• #1 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment

  Lesions caused by human papilloma virus often do not require treatment, but need to be assessed to rule out more serious conditions. […] When clinically assessing skin lesions, the following steps are useful to aid diagnosis: Inspect the patient. Where on the body are the lesions? How many lesions are there? If there are multiple lesions, do they follow a pattern or are they on a specific area? […] Any pigmented lesions should be checked for red flags suggestive of melanoma. These include: asymmetry (lack of mirror image lesion in any of the four quadrants of the body); irregular border; two or more colours in the lesion; diameter of more than 7mm. Patients presenting with any of these symptoms should be referred to a dermatologist for further assessment (e.g. biopsy and histological studies).

• #1 Common warts – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/common-warts/diagnosis-treatment/drc-20371131

  In most cases, a healthcare professional can diagnose a common wart with one or more of these techniques: […] Scraping off the top layer of the wart to check for dark, pinpoint dots, which are common in warts. […] Removing a small sample of the wart and sending it to a laboratory to rule out other types of skin growths. This is called a shave biopsy. […] Your healthcare professional will likely suggest starting treatment with the least painful method, particularly when treating young children. […] If the growths aren’t warts, what tests do you need to do?

• #1 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #1 Clinical guideline for the diagnosis and treatment of cutaneous warts (2022)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9825897/

  Acetowhite test is recommended for the diagnosis of subclinical CA. […] Remove the wart as early as possible and eliminate the subclinical infection around the wart as much as possible to reduce or prevent recurrence. […] The clinical criteria for cure of warts are complete clearance of lesions at 4 weeks and no recurrence for at least 6 months. […] Multiple warts are defined as a patient with two or more than two warts. […] Local injections with bleomycin, 5Fluorouracil (5FU), and cidofovir are suggested for refractory and recurrent common warts. […] 10% 5aminolevulinicacid photodynamic therapy (5ALAPDT) is recommended for the treatment of flat warts. […] Local hyperthermia is suggested for patients with plantar warts. […] Combination of 5% imiquimod with traditional physical therapy (lasers, cryotherapy) is recommended to treat CA. […] Podophyllotoxin and imiquimod are not recommended for CA during pregnancy, but trichloroacetic acid can be used.

• #1 Plantar warts – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697

  A health care provider usually diagnoses a plantar wart by looking at it or cutting off the top layer with a scalpel and checking for dots. The dots are tiny clotted blood vessels. Or your health care provider might cut off a small section of the growth and send it to a lab for testing. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV. […] Your health care provider may ask you questions such as: When did you first notice the wart? Has it changed in size, color or shape? Is your condition painful? Have you had warts before? Do you have diabetes or poor sensation in your feet? Do you have any condition or take any medication that has weakened your ability to fight disease (immune response)? Have you tried any home remedies? If so, how long have you used them and have they helped? Do you use a swimming pool or locker room places that can harbor wart-causing viruses?

• #1 Warts, verrucas, human papillomavirus infection

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

  In children, even without treatment, 50% of warts disappear within six months, and 90% are gone in 2 years. […] Viral warts are more persistent in adults, but they clear up eventually. They are likely to recur in patients that are immunosuppressed, for example, organ transplant recipients. Recurrence is more frequent in tobacco smokers. […] Immunity to HPV is likely to be type-specific.

• #1 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  Warts are curable. Your dermatologist knows it takes time to clear warts and that you can certainly get rid of them. […] Your dermatologist can usually diagnose warts by looking at them. […] A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Treatment can help: Clear warts more quickly. Reduce the risk of spreading the virus that causes warts to others or to other parts of your body. […] You should see a board-certified dermatologist if you have: Warts on your face or genital area, A wart that is changing, hurts, itches, burns, or bleeds, Many warts, Doubts about whether you have a wart(s), Tried at-home treatment and cannot get rid of the wart(s), A weakened immune system (e.g., cancer, HIV, organ transplant), Diabetes. […] When treatment is recommended, dermatologists offer a range of treatments.

• #1 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment

  Warts can last longer in patients who are immunocompromised, especially those with cell-mediated immunodeficiency. […] HPV infection is associated with squamous cell carcinoma and pre-malignancy. […] Most warts will resolve spontaneously within two years, although some cases can take five to ten years to resolve. […] Most warts and verrucae can be treated in primary care. […] Treatment options include salicylic acid, often in combination with lactic acid, formaldehyde, glutaraldehyde and cryotherapy. […] Topical salicylic acid (15–50% w/w), applied to the wart daily for 12 weeks, is the treatment of choice for adults and older children. […] Cryotherapy with liquid nitrogen is suitable for adults and older children who are able to tolerate it. […] Silver nitrate pencils are also available to treat cutaneous warts; however, there is no good evidence that this is effective. […] The Cochrane review also found no evidence that using duct tape to treat warts was more effective than placebo.

• #1 Warts and verrucas

  https://www.nhs.uk/conditions/warts-and-verrucas/

  Warts and verrucas are small lumps on the skin that most people have at some point in their life. […] You can treat warts if they bother you, keep coming back or are painful. […] A GP may be able to freeze a wart or verruca so it falls off a few weeks later. Sometimes it takes a few sessions. […] If treatment has not worked or you have a wart on your face, the GP might refer you to a skin specialist (dermatologist). […] If you have a large or very painful verruca, you may be referred to a foot specialist (podiatrist). […] Warts and verrucas are caused by a virus. They can be spread to other people from contaminated surfaces or through close skin contact.

• #1 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are prevalent benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] This activity reviews the diagnostic evaluation and management of warts and highlights the role of the interprofessional team in educating patients about the required follow-up for this condition. […] The diagnosis of a wart is usually made on a clinical examination and physical findings. […] Immunohistochemical detection of HPV structural proteins confirms the presence of a virus, but this has poor sensitivity. […] A biopsy is obtained if doubt exists regarding the diagnosis. […] Once the diagnosis is made, the treatment depends on symptoms, patient preferences, and cost. […] The more expensive and invasive treatments are usually reserved for multiple recurrent warts.

• #1 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are common, benign, epidermal lesions caused by human papillomavirus infection. Diagnosis is by examination. […] Diagnosis of warts is based on clinical appearance; biopsy is rarely needed. […] A cardinal sign of warts is the disruption of dermatoglyphs (characteristic superficial ridges over the fingers, palms, toes, and soles) and 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.

• #1 Warts Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/warts

  Warts are small, usually painless growths on the skin. Most of the time, they are harmless. They are caused by a virus called human papillomavirus (HPV). There are more than 150 types of HPV viruses. Some types of warts are spread through sex. […] Your health care provider will look at your skin to diagnose warts. […] You may have a skin biopsy to confirm the wart is not another type of growth, such as skin cancer. […] Genital warts are treated in a different way than most other warts.

• #2 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are prevalent benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] This activity reviews the diagnostic evaluation and management of warts and highlights the role of the interprofessional team in educating patients about the required follow-up for this condition. […] The diagnosis of a wart is usually made on a clinical examination and physical findings. […] Immunohistochemical detection of HPV structural proteins confirms the presence of a virus, but this has poor sensitivity. […] A biopsy is obtained if doubt exists regarding the diagnosis. […] Once the diagnosis is made, the treatment depends on symptoms, patient preferences, and cost. […] The more expensive and invasive treatments are usually reserved for multiple recurrent warts.

• #2 Common warts – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/common-warts/diagnosis-treatment/drc-20371131

  In most cases, a healthcare professional can diagnose a common wart with one or more of these techniques: […] Scraping off the top layer of the wart to check for dark, pinpoint dots, which are common in warts. […] Removing a small sample of the wart and sending it to a laboratory to rule out other types of skin growths. This is called a shave biopsy. […] Your healthcare professional will likely suggest starting treatment with the least painful method, particularly when treating young children. […] If the growths aren’t warts, what tests do you need to do?

• #2 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are common, benign, epidermal lesions caused by human papillomavirus infection. Diagnosis is by examination. […] Diagnosis of warts is based on clinical appearance; biopsy is rarely needed. […] A cardinal sign of warts is the disruption of dermatoglyphs (characteristic superficial ridges over the fingers, palms, toes, and soles) and 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.

• #2 Wart – Wikipedia

  https://en.wikipedia.org/wiki/Wart

  Warts are non-cancerous viral growths usually occurring on the hands and feet but which can also affect other locations, such as the genitals or face. […] They are distinguished from cancerous tumors as they are caused by a viral infection, such as a human papillomavirus, rather than a cancer growth. […] Without treatment, most types of warts resolve in months to years. […] A number of treatments may speed resolution, including salicylic acid applied to the skin and cryotherapy. […] Treatment of genital warts differs from that of other types. […] On dermatoscopic examination, warts will commonly have fingerlike or knoblike extensions. […] There are many treatments and procedures associated with wart removal. […] A review of various skin wart treatments concluded that topical treatments containing salicylic acid were more effective than placebo.

• #2 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Most warts are harmless, and many go away on their own. However, without treatment, it takes time for warts to clear from a few months to years. […] Keep in mind that results take time. […] If other treatments have not worked, your dermatologist may recommend this in-office procedure. […] Your dermatologist will carefully select your wart treatment based on your health, age, type of wart you have, and other considerations.

• #2 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  Koilocytic (vacuolated) cells are pathognomonic for warts. […] Deep palmoplantar warts appear similar to common warts except that most of the lesion lies deep to the plane of the skin surface. […] This endophytic epidermal growth often has the distinctive feature of polygonal, refractile-appearing, eosinophilic, cytoplasmic inclusions composed of keratin filaments, forming ringlike structures. […] Flat warts resemble common warts on light microscopy; however, the features tend to be muted. […] Butcher’s warts have prominent acanthosis, hyperkeratosis, and papillomatosis. […] Filiform warts may appear similar to common warts but tend to have prominent papillomatosis. […] Focal epithelial hyperplasia is characterized by a hyperplastic mucosa with thin parakeratotic stratum corneum, acanthosis, blunting and anastomosis of rete ridges, and pallor of epidermal cells as a result of intracellular edema. […] A cyst filled with horny material characterizes cystic warts.

• #2 Genital Warts: Symptoms, Causes, Diagnosis, Treatment & More

  https://www.healthline.com/health/std/genital-warts

  Genital warts can develop with a low risk HPV infection. Treatment can include topical prescription treatments and medical procedures to remove warts. […] Genital warts are soft growths that appear on the genitals. […] Treatment is key in managing this infection. […] To diagnose this condition, your doctor will do the following: Ask questions about your health and sexual history. This includes symptoms you’ve experienced and whether you’ve had sex, including oral sex, without condoms or oral dams. Perform a physical examination of any areas where you suspect warts may be occurring. Your doctor may be able to diagnose genital warts just by viewing them. […] Your doctor may apply a mild acidic solution, called an acetowhite test, to your skin to help make genital warts more visible. It may cause a slight burning sensation.

• #2 Nongenital Warts Differential Diagnoses

  https://emedicine.medscape.com/article/1133317-differential

  If a wart is extremely large and resistant to conventional therapies, consider a diagnosis of verrucous carcinoma. This is a rare, low-grade, well-differentiated carcinoma that usually occurs on the plantar surface. It is slow growing and can become deeply invasive. Reports of metastases exist, although they are rare. A verrucous carcinoma can be misdiagnosed easily as a common wart, since they two share similar clinical and histologic characteristics. Be aware of this entity, and consider a deep incisional biopsy of any lesion that is extensive and not responsive to treatment. […] A verrucous carcinoma can be misdiagnosed easily as a common wart, since they two share similar clinical and histologic characteristics. […] Be aware of this entity, and consider a deep incisional biopsy of any lesion that is extensive and not responsive to treatment.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Symptoms-and-diagnosis-of-verrucas.aspx

  Verrucas (verrucae) or plantar warts affect the pressure areas of the feet. […] Diagnosis of plantar warts or verrucae is commonly made by clinically examining them. […] The physician takes into account several factors like history of sharing community showers etc., familial or partner history of such warts as these are contagious and history of eczema and conditions where there is a risk of reduce immunity like AIDS, transplant, leukemias or lymphomas. […] The wart is examined for number, location, size, shape, colour and texture of the warts surface. […] Following examination the physician or podiatrist treating the wart may gently cut away the surface of the wart to reveal a small black dot in the centre. This confirms a verrucae. […] Blood tests may be advised to check for causes of low immunity and diabetes that result in resistant cases.

• #2 Warts: How To Identify, Causes, Types, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15045-warts

  Warts are skin growths that develop due to strains of the human papillomavirus (HPV). […] Warts are benign (noncancerous) growths that can develop on your skin and mucosa (like inside your mouth). The human papillomavirus (HPV) causes warts. […] Healthcare providers can typically diagnose warts by looking at the skin growths. In rare cases, your provider may need to do a skin biopsy to confirm that its a wart. […] Warts often go away on their own, but this can take up to two years. Because warts can spread, cause pain and affect your day-to-day life, your healthcare provider may recommend treatment. […] Certain strains of the human papillomavirus (HPV) cause warts. The virus can enter your skin through small cuts and cause extra cell growth. […] Yes, about 65% of warts go away on their own after two years. This mainly applies to people who have healthy immune systems. If youre immunocompromised, warts probably wont go away on their own.

• #2 Verrucae (Plantar Warts and Myrmecia Verrucae) | Doctor

  https://patient.info/doctor/verrucae

  Secondary care referral may be necessary in the following situations: Facial wart. Diagnosis is uncertain. Person is immunocompromised. Areas of skin that are extensively affected – eg, mosaic warts of the hands and feet. Persistent warts that are unresponsive to both topical salicylic acid and cryotherapy. […] Diagnosis is made by examination and observation of typical features.

• #2 Warts, verrucas, human papillomavirus infection

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

  Warts are particularly common in: […] Cutaneous viral warts are usually diagnosed clinically. Clinical clues to diagnosis can include: […] Dermoscopy assists visualisation of the papillary capillaries of a viral wart, and can distinguish other verrucous lesions such as a seborrhoeic keratosis. […] Skin biopsy is sometimes required when squamous cell carcinoma cannot be excluded clinically such as in an organ transplant recipient susceptible to both. […] Differential diagnoses for a cutaneous viral wart can include: […] Treatment may not be required in all cases as most warts resolve spontaneously especially in children. Indications for active treatment include: […] Treatments do not kill the virus, but work by removing virus-containing skin. […] No treatment is universally effective at eradicating viral warts.

• #2 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  Warts are curable. Your dermatologist knows it takes time to clear warts and that you can certainly get rid of them. […] Your dermatologist can usually diagnose warts by looking at them. […] A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Treatment can help: Clear warts more quickly. Reduce the risk of spreading the virus that causes warts to others or to other parts of your body. […] You should see a board-certified dermatologist if you have: Warts on your face or genital area, A wart that is changing, hurts, itches, burns, or bleeds, Many warts, Doubts about whether you have a wart(s), Tried at-home treatment and cannot get rid of the wart(s), A weakened immune system (e.g., cancer, HIV, organ transplant), Diabetes. […] When treatment is recommended, dermatologists offer a range of treatments.

• #2 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  The diagnosis of a wart is usually made on a clinical examination and physical findings. […] The majority of warts do not cause symptoms. However, they do cause cosmetic disfigurement and, in a rare patient, may cause localized pain. […] Close to two-thirds of warts resolve spontaneously over several years, so the efficacy of treatments is difficult to discern. […] Irrespective of the treatment selected, failures and recurrence are common. Most warts resolve spontaneously. […] To obtain the best outcomes, the management of warts should be under an interprofessional team.

• #2 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #2 Clinical guideline for the diagnosis and treatment of cutaneous warts (2022)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9825897/

  Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidencebased guidelines to guide clinical practice are urgently needed. […] Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. […] Typical viral warts can be diagnosed by clinical visual examination. Pathological examination and HPV genotyping are recommended in cases of atypical lesions (suspected precancerous lesions or cancer) and in cases where the diagnosis is uncertain.

• #3 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are common, benign, epidermal lesions caused by human papillomavirus infection. Diagnosis is by examination. […] Diagnosis of warts is based on clinical appearance; biopsy is rarely needed. […] A cardinal sign of warts is the disruption of dermatoglyphs (characteristic superficial ridges over the fingers, palms, toes, and soles) and 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.

• #3 Plantar warts – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plantar-warts/diagnosis-treatment/drc-20352697

  A health care provider usually diagnoses a plantar wart by looking at it or cutting off the top layer with a scalpel and checking for dots. The dots are tiny clotted blood vessels. Or your health care provider might cut off a small section of the growth and send it to a lab for testing. […] If a plantar wart goes away after treatment and another wart grows, it could be because the area was exposed again to HPV. […] Your health care provider may ask you questions such as: When did you first notice the wart? Has it changed in size, color or shape? Is your condition painful? Have you had warts before? Do you have diabetes or poor sensation in your feet? Do you have any condition or take any medication that has weakened your ability to fight disease (immune response)? Have you tried any home remedies? If so, how long have you used them and have they helped? Do you use a swimming pool or locker room places that can harbor wart-causing viruses?

• #3

  https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx

  Plantar warts, also known as plantar verrucae, are manifestations of infection with human papillomavirus. Diagnosis is based on clinical appearance. Plantar warts can be confused with corns or calluses. The use of a hand-held dermatoscope can assist in diagnosis for practitioners trained in its use. Warts are characterised by hyperkeratosis or thickening of the skin, and are often found on pressure points. Although rare, the most important differential diagnosis in a patient with a suspected plantar wart is melanoma. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. All topical treatments for warts have variable success rates, therefore several different management methods may need to be trialled before the wart is resolved. Topical treatment with salicylic acid is often regarded as a first-line approach to treating plantar warts. The wart should be gently abraded with an emery board or pumice stone once a week.

• #3 Warts, verrucas, human papillomavirus infection

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

  Warts are particularly common in: […] Cutaneous viral warts are usually diagnosed clinically. Clinical clues to diagnosis can include: […] Dermoscopy assists visualisation of the papillary capillaries of a viral wart, and can distinguish other verrucous lesions such as a seborrhoeic keratosis. […] Skin biopsy is sometimes required when squamous cell carcinoma cannot be excluded clinically such as in an organ transplant recipient susceptible to both. […] Differential diagnoses for a cutaneous viral wart can include: […] Treatment may not be required in all cases as most warts resolve spontaneously especially in children. Indications for active treatment include: […] Treatments do not kill the virus, but work by removing virus-containing skin. […] No treatment is universally effective at eradicating viral warts.

• #3 Verruca vulgaris – Libre Pathology

  https://librepathology.org/wiki/Verruca_vulgaris

  Verruca vulgaris. HE stain. LM papillomatous hyperplasia (rete ridges long curve inward), hyperkeratosis, hypergranulosis, large blood vessels at the dermal-epidermal junction, +/-viral changes – perinuclear halo, nucleus small and hyperchromatic (virtually diagnostic when present), +/-binucleation […] +/-Viral changes – perinuclear halo, nucleus small and hyperchromatic – virtually diagnostic when present. […] The sections show skin with elongated rete ridges, acanthosis, hypergranulosis, hyperkeratosis in vertical columns, focal parakeratosis, dilated blood vessels at the dermal-epidermal junction and koilocytic change. Mild basilar nuclear atypia is present. […] The sections show skin with elongated rete ridges that curve toward the centre of the lesion, acanthosis, hypergranulosis, hyperkeratosis in vertical columns, and dilated blood vessels at the dermal-epidermal junction. Minimal basilar nuclear enlargement is present. No definite koilocytic change is apparent.

• #3 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #3 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment

  Lesions caused by human papilloma virus often do not require treatment, but need to be assessed to rule out more serious conditions. […] When clinically assessing skin lesions, the following steps are useful to aid diagnosis: Inspect the patient. Where on the body are the lesions? How many lesions are there? If there are multiple lesions, do they follow a pattern or are they on a specific area? […] Any pigmented lesions should be checked for red flags suggestive of melanoma. These include: asymmetry (lack of mirror image lesion in any of the four quadrants of the body); irregular border; two or more colours in the lesion; diameter of more than 7mm. Patients presenting with any of these symptoms should be referred to a dermatologist for further assessment (e.g. biopsy and histological studies).

• #3 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Symptoms-and-diagnosis-of-verrucas.aspx

  Verrucas (verrucae) or plantar warts affect the pressure areas of the feet. […] Diagnosis of plantar warts or verrucae is commonly made by clinically examining them. […] The physician takes into account several factors like history of sharing community showers etc., familial or partner history of such warts as these are contagious and history of eczema and conditions where there is a risk of reduce immunity like AIDS, transplant, leukemias or lymphomas. […] The wart is examined for number, location, size, shape, colour and texture of the warts surface. […] Following examination the physician or podiatrist treating the wart may gently cut away the surface of the wart to reveal a small black dot in the centre. This confirms a verrucae. […] Blood tests may be advised to check for causes of low immunity and diabetes that result in resistant cases.

• #3 Common warts – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/common-warts/diagnosis-treatment/drc-20371131

  In most cases, a healthcare professional can diagnose a common wart with one or more of these techniques: […] Scraping off the top layer of the wart to check for dark, pinpoint dots, which are common in warts. […] Removing a small sample of the wart and sending it to a laboratory to rule out other types of skin growths. This is called a shave biopsy. […] Your healthcare professional will likely suggest starting treatment with the least painful method, particularly when treating young children. […] If the growths aren’t warts, what tests do you need to do?

• #3 Verrucae (Plantar Warts and Myrmecia Verrucae) | Doctor

  https://patient.info/doctor/verrucae

  Secondary care referral may be necessary in the following situations: Facial wart. Diagnosis is uncertain. Person is immunocompromised. Areas of skin that are extensively affected – eg, mosaic warts of the hands and feet. Persistent warts that are unresponsive to both topical salicylic acid and cryotherapy. […] Diagnosis is made by examination and observation of typical features.

• #3 Warts: How To Identify, Causes, Types, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15045-warts

  Warts are skin growths that develop due to strains of the human papillomavirus (HPV). […] Warts are benign (noncancerous) growths that can develop on your skin and mucosa (like inside your mouth). The human papillomavirus (HPV) causes warts. […] Healthcare providers can typically diagnose warts by looking at the skin growths. In rare cases, your provider may need to do a skin biopsy to confirm that its a wart. […] Warts often go away on their own, but this can take up to two years. Because warts can spread, cause pain and affect your day-to-day life, your healthcare provider may recommend treatment. […] Certain strains of the human papillomavirus (HPV) cause warts. The virus can enter your skin through small cuts and cause extra cell growth. […] Yes, about 65% of warts go away on their own after two years. This mainly applies to people who have healthy immune systems. If youre immunocompromised, warts probably wont go away on their own.

• #3 Warts, verrucas, human papillomavirus infection

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

  In children, even without treatment, 50% of warts disappear within six months, and 90% are gone in 2 years. […] Viral warts are more persistent in adults, but they clear up eventually. They are likely to recur in patients that are immunosuppressed, for example, organ transplant recipients. Recurrence is more frequent in tobacco smokers. […] Immunity to HPV is likely to be type-specific.

• #3 Clinical guideline for the diagnosis and treatment of cutaneous warts (2022)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9825897/

  Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidencebased guidelines to guide clinical practice are urgently needed. […] Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. […] Typical viral warts can be diagnosed by clinical visual examination. Pathological examination and HPV genotyping are recommended in cases of atypical lesions (suspected precancerous lesions or cancer) and in cases where the diagnosis is uncertain.

• #3 Warts: Types, Symptoms, Causes, Treatment, and More

  https://www.verywellhealth.com/what-you-need-to-know-about-warts-1068906

  Warts are easy to diagnose. Most people can recognize a wart on their own body, particularly if they have had one before. If you’re not sure what it is, your healthcare provider can likely diagnose it just by looking. […] Warts on the face or genitals or those that are changing in color or shape or are bleeding should be seen by a healthcare provider. […] If your provider suspects skin cancer or a precancerous growth, they may order a skin biopsy. This is where a small piece of tissue is removed and examined under a microscope. This isn’t necessary for most warts. […] Warts can be diagnosed visually. Treatment options include OTC or prescription medications applied to the skin or specialist in-office procedures like cryotherapy or electrodesiccation.

• #4 Plantar wart – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_wart

  A plantar wart is a small lesion that appears on the surface of the skin and typically resembles a cauliflower, with tiny black petechiae (tiny hemorrhages under the skin) in the center. […] Diagnosis is typically based on symptoms. […] Plantar warts are often similar to calluses or corns, but can be differentiated by close observation of skin striations. […] Plantar warts tend to be painful on application of pressure from either side of the lesion rather than direct pressure, unlike corns (which tend to be painful on direct pressure, instead).

• #4 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment

  Cutaneous warts are generally diagnosed on appearance. The characteristic appearance of different types of warts are as follows: Common warts are firm and raised with rough edges like a cauliflower; Plane warts are round, flat-topped and yellow, and they are commonly seen on the back of hands; Filiform warts are long, finger-like warts common on the face and neck; Palmar and plantar warts grow on palms (palmar) and soles of feet (plantar). Often seen with thrombosed capillaries, which appear as a central black dot (these do not appear in corns and calluses); Periungual warts occur around fingernails and toenails, and appear as thickened, cauliflower-like skin; Mosaic warts are multiple palmar or plantar warts that coalesce on hands or feet. […] If the diagnosis is in doubt, paring down a wart with a file will result in pinpoint bleeding from thrombosed capillaries.

• #4 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  Koilocytic (vacuolated) cells are pathognomonic for warts. […] Deep palmoplantar warts appear similar to common warts except that most of the lesion lies deep to the plane of the skin surface. […] This endophytic epidermal growth often has the distinctive feature of polygonal, refractile-appearing, eosinophilic, cytoplasmic inclusions composed of keratin filaments, forming ringlike structures. […] Flat warts resemble common warts on light microscopy; however, the features tend to be muted. […] Butcher’s warts have prominent acanthosis, hyperkeratosis, and papillomatosis. […] Filiform warts may appear similar to common warts but tend to have prominent papillomatosis. […] Focal epithelial hyperplasia is characterized by a hyperplastic mucosa with thin parakeratotic stratum corneum, acanthosis, blunting and anastomosis of rete ridges, and pallor of epidermal cells as a result of intracellular edema. […] A cyst filled with horny material characterizes cystic warts.

• #4 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #4

  https://bpac.org.nz/BPJ/2014/December/plantar-warts.aspx

  Plantar warts, also known as plantar verrucae, are manifestations of infection with human papillomavirus. Diagnosis is based on clinical appearance. Plantar warts can be confused with corns or calluses. The use of a hand-held dermatoscope can assist in diagnosis for practitioners trained in its use. Warts are characterised by hyperkeratosis or thickening of the skin, and are often found on pressure points. Although rare, the most important differential diagnosis in a patient with a suspected plantar wart is melanoma. […] Up to 80% of people will experience resolution of plantar warts without intervention within two years. All topical treatments for warts have variable success rates, therefore several different management methods may need to be trialled before the wart is resolved. Topical treatment with salicylic acid is often regarded as a first-line approach to treating plantar warts. The wart should be gently abraded with an emery board or pumice stone once a week.

• #4 Verrucae (Plantar Warts and Myrmecia Verrucae) | Doctor

  https://patient.info/doctor/verrucae

  Verrucae are caused by the human papillomavirus (HPV), particularly types 1, 2, 4, 27 and 572. They affect epithelial cells causing small rough papules. Replication of the virus within the epithelial cells causes a proliferative reaction and formation of plaque or papule. Incubation is very variable, ranging from one month to over a year. […] Diagnosis is made by examination and observation of typical features. […] None is usually required or appropriate. Distinguishing them from corns may require paring of the keratin. Blood tests to check for causes of immunodeficiency may be required in unusually widespread or resistant cases. […] Treatment is not necessarily required if the verruca is not painful. However, a wart on the sole of the foot is more likely to cause discomfort than warts in other areas such as the hands.

• #4 Warts and verrucas

  https://www.nhs.uk/conditions/warts-and-verrucas/

  Warts and verrucas are small lumps on the skin that most people have at some point in their life. […] You can treat warts if they bother you, keep coming back or are painful. […] A GP may be able to freeze a wart or verruca so it falls off a few weeks later. Sometimes it takes a few sessions. […] If treatment has not worked or you have a wart on your face, the GP might refer you to a skin specialist (dermatologist). […] If you have a large or very painful verruca, you may be referred to a foot specialist (podiatrist). […] Warts and verrucas are caused by a virus. They can be spread to other people from contaminated surfaces or through close skin contact.

• #4 Plantar warts (verrucas) – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/plantar-warts-verrucas/

  Warts are localised thickenings of the skin, and the term plantar warts is used for those that occur on the soles of the feet (the plantar surface). They are also known as verrucas. […] The diagnosis is usually based on the clinical appearance. Sometimes it can be difficult to tell a plantar wart from a corn. Your doctor may need to pare the area down to find the black dots that confirm the diagnosis of a viral wart. No other investigations are usually needed. […] There is no guaranteed cure, but some treatments can help to clear warts. The best chance of cure is in young people who have not had their warts for very long. […] Most plantar warts can be managed with advice from your pharmacist and with use of over-the counter topical treatments. […] Up to 65% of viral warts including plantar warts resolve by themselves without any treatment within two years of appearing. […] Surgical removal of warts is an option if topical treatments do not work. Options include tissue destructive laser therapy or curettage and cautery after a local anaesthetic injection into the skin.

• #4 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Most warts are harmless, and many go away on their own. However, without treatment, it takes time for warts to clear from a few months to years. […] Keep in mind that results take time. […] If other treatments have not worked, your dermatologist may recommend this in-office procedure. […] Your dermatologist will carefully select your wart treatment based on your health, age, type of wart you have, and other considerations.

• #5 Plantar Warts (Verrucas) – Sussex Community Dermatology Service

  https://sussexcds.co.uk/patient-information/plantar-warts-verrucas/

  Warts are localised thickenings of the skin, and the term plantar warts is used for those that occur on the soles of the feet (the plantar surface). They are also known as verrucas. […] Usually this is easy, and based simply on the appearance. However, sometimes it may be hard to tell a plantar wart from a corn. One helpful point is that plantar warts interrupt the fine skin ridges on the sole, whereas corns do not. Your doctor may need to pare down the area to be certain of the diagnosis; he/she will be looking for the small black dots which confirm the diagnosis of a viral wart. No other investigations are needed. […] Yes, but no single treatment can be guaranteed to be effective in every case. The highest cure rates are in young people who have not had their warts for very long. However, most verrucas will go away by themselves in due course, so it is very reasonable to leave them alone if they are not causing trouble.

• #5 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Symptoms-and-diagnosis-of-verrucas.aspx

  Verrucas (verrucae) or plantar warts affect the pressure areas of the feet. […] Diagnosis of plantar warts or verrucae is commonly made by clinically examining them. […] The physician takes into account several factors like history of sharing community showers etc., familial or partner history of such warts as these are contagious and history of eczema and conditions where there is a risk of reduce immunity like AIDS, transplant, leukemias or lymphomas. […] The wart is examined for number, location, size, shape, colour and texture of the warts surface. […] Following examination the physician or podiatrist treating the wart may gently cut away the surface of the wart to reveal a small black dot in the centre. This confirms a verrucae. […] Blood tests may be advised to check for causes of low immunity and diabetes that result in resistant cases.

• #5 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #5 Warts and Verrucas: Causes and Treatment

  https://patient.info/skin-conditions/warts-and-verrucas-leaflet

  Warts are usually harmless but may be unsightly. Warts and verrucas usually clear in time without treatment. If required, they can often be cleared more quickly with treatment. Most commonly, treatment involves applying salicylic acid or freezing with liquid nitrogen or a cold spray. […] Warts are small rough lumps on the skin. Verrucas are warts on the feet. They are caused by a virus (human papillomavirus) which causes a reaction in the skin. Warts can occur anywhere on the body but occur most commonly on hands and feet. […] Warts are generally harmless, and usually disappear on their own, although this can take some time. About two-thirds of warts go away without treatment within two years. […] The most commonly used treatments are: Salicylic acid. Freezing treatment. […] Freezing warts may also be effective. Many GPs and practice nurses are skilled at this. You can also get private treatment with cryotherapy from podiatrists. Liquid nitrogen is commonly used.

• #5 Clinical guideline for the diagnosis and treatment of cutaneous warts (2022)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9825897/

  Acetowhite test is recommended for the diagnosis of subclinical CA. […] Remove the wart as early as possible and eliminate the subclinical infection around the wart as much as possible to reduce or prevent recurrence. […] The clinical criteria for cure of warts are complete clearance of lesions at 4 weeks and no recurrence for at least 6 months. […] Multiple warts are defined as a patient with two or more than two warts. […] Local injections with bleomycin, 5Fluorouracil (5FU), and cidofovir are suggested for refractory and recurrent common warts. […] 10% 5aminolevulinicacid photodynamic therapy (5ALAPDT) is recommended for the treatment of flat warts. […] Local hyperthermia is suggested for patients with plantar warts. […] Combination of 5% imiquimod with traditional physical therapy (lasers, cryotherapy) is recommended to treat CA. […] Podophyllotoxin and imiquimod are not recommended for CA during pregnancy, but trichloroacetic acid can be used.

• #5 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are prevalent benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] This activity reviews the diagnostic evaluation and management of warts and highlights the role of the interprofessional team in educating patients about the required follow-up for this condition. […] The diagnosis of a wart is usually made on a clinical examination and physical findings. […] Immunohistochemical detection of HPV structural proteins confirms the presence of a virus, but this has poor sensitivity. […] A biopsy is obtained if doubt exists regarding the diagnosis. […] Once the diagnosis is made, the treatment depends on symptoms, patient preferences, and cost. […] The more expensive and invasive treatments are usually reserved for multiple recurrent warts.

• #6 Nongenital Warts Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1133317-workup

  The diagnosis of warts is made primarily on the basis of clinical findings. […] Immunohistochemical detection of HPV structural proteins may confirm the presence of virus in a lesion, but this has a low sensitivity. […] Viral DNA identification using Southern blot hybridization is a more sensitive and specific technique used to identify the specific HPV type present in tissue. […] Polymerase chain reaction may be used to amplify viral DNA for testing. […] Although HPV may be detected in younger lesions, it may not be present in older lesions. […] Obtain a biopsy if doubt exists regarding the diagnosis. […] Histopathologic features of common warts include digitated epidermal hyperplasia, acanthosis, papillomatosis, compact orthokeratosis, hypergranulosis, dilated tortuous capillaries within the dermal papillae, and vertical tiers of parakeratotic cells with entrapped red blood cells above the tips of the digitations.

• #6 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  Warts are curable. Your dermatologist knows it takes time to clear warts and that you can certainly get rid of them. […] Your dermatologist can usually diagnose warts by looking at them. […] A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Treatment can help: Clear warts more quickly. Reduce the risk of spreading the virus that causes warts to others or to other parts of your body. […] You should see a board-certified dermatologist if you have: Warts on your face or genital area, A wart that is changing, hurts, itches, burns, or bleeds, Many warts, Doubts about whether you have a wart(s), Tried at-home treatment and cannot get rid of the wart(s), A weakened immune system (e.g., cancer, HIV, organ transplant), Diabetes. […] When treatment is recommended, dermatologists offer a range of treatments.

• #7 Warts: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/warts-treatment

  A skin biopsy can tell your dermatologist if you have a wart or another skin condition. […] Most warts are harmless, and many go away on their own. However, without treatment, it takes time for warts to clear from a few months to years. […] Keep in mind that results take time. […] If other treatments have not worked, your dermatologist may recommend this in-office procedure. […] Your dermatologist will carefully select your wart treatment based on your health, age, type of wart you have, and other considerations.

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