Brodawki i kurzajki – Patofizjologia i mechanizm

Brodawki i kurzajki
Patofizjologia i mechanizm

Brodawki i kurzajki to łagodne zmiany skórne wywoływane przez wirusa brodawczaka ludzkiego (HPV), głównie typów 1, 2, 4, 7, 27, 29 i 57. Infekcja rozpoczyna się przez mikrourazy skóry, a wirus replikuje się w warstwie podstawnej naskórka, prowadząc do hiperplazji, hiperkeratozy oraz powstawania charakterystycznych koilocytów. Okres inkubacji wynosi od 2 do 6 miesięcy, a nawet do roku. HPV unika rozpoznania przez układ odpornościowy, co umożliwia długotrwałe przetrwanie wirusa w skórze. Odpowiedź immunologiczna, zwłaszcza komórkowa z udziałem limfocytów T CD8+, jest kluczowa dla eliminacji wirusa i regresji brodawek. Czynniki ryzyka obejmują immunosupresję, uszkodzenia skóry, wilgotne środowisko oraz kontakt z zakażonymi powierzchniami. Brodawki mają tendencję do samoistnej regresji w około 65% przypadków w ciągu 2 lat, jednak nawroty są częste, zwłaszcza u pacjentów z obniżoną odpornością.

Patogeneza brodawek i kurzajek

Brodawki i kurzajki to łagodne zmiany skórne wywoływane przez wirusa brodawczaka ludzkiego (HPV – Human Papillomavirus). HPV stanowi dużą grupę wirusów, składającą się z ponad 150-200 różnych typów, z których tylko określone szczepy powodują brodawki na skórze i błonach śluzowych.¹²³ Do najczęściej występujących typów HPV powodujących brodawki zwykłe oraz kurzajki (brodawki podeszwowe) zalicza się typy 1, 2, 4, 7, 27, 29 i 57.⁴⁵

Infekcja wirusem HPV

Proces infekcji rozpoczyna się, gdy wirus HPV przedostaje się do warstwy podstawnej naskórka przez niewielkie uszkodzenia skóry, takie jak mikrourazy, zadrapania, pęknięcia lub obszary osłabionej skóry.⁶⁷ Szczególnie podatne na zakażenie są miejsca, gdzie skóra jest uszkodzona, zmacerowana lub wilgotna, co tłumaczy częste występowanie kurzajek w okolicach basenów czy publicznych pryszniców.⁸⁹

Po wniknięciu do naskórka, wirus HPV zakaża komórki warstwy podstawnej i rozpoczyna proces replikacji. Okres inkubacji wirusa może być długi i wynosi od 2 do 6 miesięcy, a w niektórych przypadkach nawet do roku.¹⁰¹¹¹² W tym czasie wirus może pozostawać uśpiony, nie wywołując widocznych objawów.

Mechanizm rozwoju brodawek

Po wniknięciu do komórek naskórka, wirus HPV przejmuje kontrolę nad mechanizmami komórkowymi gospodarza i wywołuje szereg zmian patofizjologicznych:¹³

Białka wirusowe E6 i E7 zakłócają mechanizmy kontrolne cyklu komórkowego, co prowadzi do niekontrolowanej proliferacji komórek¹⁴
Dochodzi do replikacji genomu wirusa z podwyższonym poziomem białek E1, E2, E4 i E5¹⁵
HPV indukuje hiperplazję i hiperkeratozę – nadmierne namnażanie komórek naskórka i zwiększone wytwarzanie keratyny¹⁶¹⁷
W górnych warstwach naskórka pojawiają się charakterystyczne wakuolizowane keratynocyty (koilocyty), które posiadają małe, obkurczone jądro otoczone okołojądrowym halo¹⁸

W wyniku tych procesów powstaje charakterystyczny obraz histopatologiczny brodawki, który obejmuje:¹⁹

Pogrubienie warstwy rogowej naskórka (hiperkeratoza)
Pogrubienie warstwy kolczystej (akantoza)
Pogrubienie warstwy ziarnistej
Wydłużenie sopli naskórkowych
Powiększone naczynia krwionośne w połączeniu skórno-naskórkowym

Rozmnażanie i rozprzestrzenianie wirusa

Cykl życiowy HPV jest ściśle związany z różnicowaniem się keratynocytów. Wiriony HPV są wytwarzane w górnych warstwach naskórka i uwalniane wraz ze złuszczającymi się komórkami naskórka.²⁰²¹ Cząsteczki wirusa mogą następnie zakażać kolejne obszary skóry lub przenosić się na inne osoby.

Brodawki zawierają duży ładunek wirusowy, co zwiększa wskaźnik rozsiewu wirusa i prawdopodobieństwo zakażenia sąsiednich powierzchni ciała, nieożywionych powierzchni wspólnych lub bliskich kontaktów.²² Im dłużej brodawka pozostaje na skórze, tym większa jest jej zdolność do przenoszenia infekcji.²³

Odpowiedź immunologiczna na HPV

System immunologiczny odgrywa kluczową rolę w kontrolowaniu infekcji HPV. U większości zdrowych osób, odpowiedź immunologiczna rozpoczyna się w momencie kontaktu z cząsteczką HPV.²⁴

Rola odporności komórkowej i humoralnej

Kluczowe znaczenie w zwalczaniu ustalonej infekcji HPV ma odporność komórkowa, szczególnie za pośrednictwem limfocytów T CD8+.²⁵ Jednakże również nienaruszona odporność humoralna może zapewnić ochronę przed infekcją HPV.²⁶

W przypadku skutecznej odpowiedzi immunologicznej, dochodzi do eliminacji wirusa i regresji brodawki. Jeśli jednak ten proces zawiedzie, tworzy się przetrwała brodawka.²⁷ U osób z zaburzoną odpornością komórkową (np. pacjentów z HIV, po przeszczepach narządów, podczas leczenia immunosupresyjnego) istnieje szczególne ryzyko rozwoju uogólnionych zmian, które trudno poddają się leczeniu.²⁸²⁹

Mechanizmy unikania odpowiedzi immunologicznej

HPV posiada zdolność do unikania rozpoznania przez układ odpornościowy. Ponieważ HPV aktywuje limfocyty T supresorowe i zmienia funkcję komórek Langerhansa, układ odpornościowy nie wykrywa wirusa i w związku z tym nie może z nim walczyć.³⁰ To pozwala wirusowi na długotrwałe przetrwanie w skórze.

Dodatkowo, HPV zakaża tylko zewnętrzną warstwę skóry (naskórek), nie wywołuje wiremii, a replikacja wirusowa i złuszczanie wirionów następuje w komórkach już przeznaczonych do złuszczania, co ogranicza ekspozycję antygenów wirusowych na system immunologiczny.³¹

Drogi transmisji i czynniki ryzyka

Sposoby przenoszenia wirusa HPV

HPV może być przenoszony następującymi drogami:³²³³

Bezpośredni kontakt skóra-skóra z osobą zakażoną
Pośredni kontakt poprzez skażone powierzchnie lub przedmioty (fomity)
Autoinokulacja – przeniesienie wirusa z jednej części ciała na drugą poprzez drapanie, dotykanie lub pocieranie

Wirus jest stosunkowo odporny na wiele powszechnych środków dezynfekujących. Do inaktywacji patogenu skuteczne są: 90% etanol (ekspozycja co najmniej 1 minutę), 2% aldehyd glutarowy, 30% Savlon i/lub 1% podchloryn sodu.³⁴ Wirus jest odporny na wysychanie i ciepło, ale ginie w temperaturze 100°C oraz pod wpływem promieniowania ultrafioletowego.³⁵

Czynniki zwiększające ryzyko infekcji

Czynniki zwiększające ryzyko rozwoju brodawek i kurzajek obejmują:³⁶³⁷

Osłabiony układ odpornościowy – osoby z niedoborami odporności, przyjmujące leki immunosupresyjne, przechodzące chemioterapię lub z chorobami takimi jak HIV/AIDS są bardziej podatne na infekcje HPV
Uszkodzenia skóry – wszelkie skaleczenia, zadrapania lub przerwanie ciągłości skóry tworzą wrota dla wirusa HPV
Wilgotne środowisko – HPV rozwija się w ciepłych, wilgotnych miejscach, co wyjaśnia częste występowanie kurzajek na podeszwach stóp
Kontakt z zakażonymi powierzchniami – chodzenie boso w publicznych prysznicach, szatniach czy basenach
Wiek – dzieci i nastolatki są bardziej podatne na brodawki ze względu na nieukształtowany w pełni układ odpornościowy

Potencjał onkogenny HPV

Chociaż większość typów HPV powodujących brodawki zwykłe i kurzajki ma niski potencjał onkogenny, niektóre szczepy HPV mogą prowadzić do rozwoju nowotworów.³⁸

Typy HPV o wysokim ryzyku onkogennym

Spośród ponad 100 podtypów HPV, kilka z nich wykazuje zdolność do indukowania nowotworów. Do tych szczepów należą HPV 6, 11, 16, 18, 31 i 35.³⁹ Transformacja nowotworowa występuje zwykle u osób z brodawkami narządów płciowych oraz u osób z upośledzoną odpornością. Szczepy HPV 5, 8, 20 i 47 mają również potencjał złośliwy u osób z epidermodysplasia verruciformis.⁴⁰

Warto jednak podkreślić, że szczepy HPV powodujące zwykłe brodawki skórne są odmienne od tych wywołujących brodawki narządów płciowych i raka szyjki macicy.⁴¹⁴²

Rzadkie przypadki transformacji nowotworowej

Brodawki ogólnie mają charakter łagodny, jednak istnieją doniesienia, że czasami mogą one stać się złośliwe i rozwinąć się w nowotwór znany jako rak brodawkujący (verrucous carcinoma).⁴³⁴⁴

Rak brodawkujący jest wolno rosnącym guzem i jest klasyfikowany jako dobrze zróżnicowany nowotwór złośliwy pochodzenia nabłonkowego, często mylony ze zwykłą brodawką. Choć może wystąpić na każdej części ciała, najczęściej pojawia się na powierzchni podeszwowej. Rak brodawkujący rzadko daje przerzuty, ale jest miejscowo niszczący.⁴⁵⁴⁶

Złośliwa transformacja brodawek nienarzędów płciowych jest rzadka, ale występuje częściej u pacjentów z obniżoną odpornością.⁴⁷

Spontaniczna regresja i nawroty

Jedną z charakterystycznych cech brodawek jest ich zdolność do spontanicznej regresji oraz tendencja do nawrotów.⁴⁸

Samoistne ustępowanie brodawek

Około 65% brodawek zanika samoistnie w ciągu 2 lat bez leczenia.⁴⁹ U dzieci takie samoistne ustępowanie może wynikać z rozwijającej się z wiekiem odporności na wirusa HPV.⁵⁰

Regresja brodawek związana jest z degeneracją komórek podstawnych, degeneracją naskórka i zakrzepicą naczyń.⁵¹ Gdy brodawki ustępują samoistnie, nie pozostawiają blizn. Jednak blizny mogą powstać w wyniku różnych metod leczenia.⁵²

Przyczyny nawrotów

Niepowodzenia w leczeniu i nawroty brodawek są powszechne, szczególnie u pacjentów z obniżoną odpornością.⁵³ Normalnie wyglądająca skóra wokół zmiany może zawierać HPV, co pomaga wyjaśnić nawroty.⁵⁴

Należy podkreślić, że nie ma leku na HPV, więc część wirusa może pozostać w skórze nawet po ustąpieniu brodawki i pojawić się ponownie później.⁵⁵ Wirus może pozostawać w organizmie przez całe życie, a kurzajki mogą ponownie się pojawić, gdy układ odpornościowy jest osłabiony z jakiegokolwiek powodu.⁵⁶

Czynniki wpływające na nawroty wydają się być związane zarówno z ogólnym stanem immunologicznym pacjenta, jak i czynnikami lokalnymi.⁵⁷

Mechanizmy działania terapii przeciwko brodawkom

Leczenie brodawek i kurzajek opiera się na różnych mechanizmach działania, gdyż obecnie nie ma specyficznego leczenia przeciwwirusowego skierowanego bezpośrednio przeciwko HPV.⁵⁸

Terapie destrukcyjne

Większość tradycyjnych terapii przeciwko brodawkom można sklasyfikować jako destrukcyjne lub immunomodulujące.⁵⁹ Terapie destrukcyjne można dalej podzielić na te, które mają charakter farmakologiczny lub fizyczny:

Kwas salicylowy – działa poprzez usuwanie skóry warstwami, co z czasem eliminuje brodawkę. Kwas również podrażnia obszar brodawki, zachęcając układ odpornościowy do reagowania na wirusa.⁶⁰
Krioterapia – proces zamrażania i rozmrażania niszczy tkankę brodawki i jest jedną z najczęściej stosowanych metod leczenia.⁶¹ Krioterapia działa poprzez niszczenie zakażonych komórek za pomocą cytolizy indukowanej termicznie.⁶²
Kwas trójchlorooctowy (TCA) i kwas dichlorooctowy (DCA) – są to substancje żrące, które niszczą brodawki poprzez chemiczną koagulację białek.⁶³

Terapie immunomodulujące

Terapie immunomodulujące koncentrują się na stymulowaniu układu odpornościowego do zwalczania infekcji HPV:⁶⁴

Miejscowe środki drażniące – działają poprzez skierowanie odpowiedzi immunologicznej na drażniący czynnik, który następnie atakuje także zmianę HPV.⁶⁵
Imikwimod – zwiększa działanie przeciwnowotworowe i przeciwwirusowe poprzez stymulację produkcji określonych cytokin, które modulują odpowiedź immunologiczną.⁶⁶
Alergeny kontaktowe – terapie z wykorzystaniem difenylcyklopropanonu (DPCP) i dibutylesteru kwasu skwaresynowego (SADBE) wywołują reakcję nadwrażliwości typu IV, aby zmobilizować układ odpornościowy.⁶⁷
Nakłuwanie kurzajek (verruca needling) – działa poprzez stymulowanie własnej odpowiedzi immunologicznej organizmu do zwalczania wirusa.⁶⁸⁶⁹

Terapie bezpośrednio przeciwwirusowe

Bezpośrednie działanie przeciwwirusowe można osiągnąć poprzez iniekcję wewnątrzzmianową bleomycyny i interferonu alfa-2b, ale te metody leczenia są zarezerwowane dla najbardziej opornych brodawek.⁷⁰ Przeciwciała monoklonalne również mogą być stosowane w leczeniu opornych brodawek.

Intralesionalne antygeny, takie jak candida, świnka i trichophyton, są wstrzykiwane do brodawki, aby pomóc w wywołaniu odpowiedzi immunologicznej komórkowej.⁷¹

Nowoczesne podejścia terapeutyczne

Nowsze metody leczenia obejmują terapię mikrofalową Swift, która wykorzystuje precyzyjne dawki energii mikrofalowej dostarczanej bezpośrednio przez sondę, ogrzewając i niszcząc kurzajkę.⁷²⁷³

Kantarydyna, znana również jako „sok z chrząszcza”, ponieważ jest pozyskiwana z wydzielin chrząszczy z rodziny Meloidae, powoduje zniszczenie komórek nabłonkowych poprzez tworzenie pęcherzy wokół zmienionego obszaru.⁷⁴⁷⁵

Warto podkreślić, że skuteczność różnych metod leczenia może się różnić w zależności od czynników takich jak grubość brodawki, jej lokalizacja na ciele oraz indywidualny układ odpornościowy pacjenta.⁷⁶

Podsumowując, leczenia nie zabijają wirusa, ale działają poprzez usuwanie skóry zawierającej wirusa. Wytrwałość w leczeniu i cierpliwość są niezbędne, ponieważ HPV zakaża warstwę komórek podstawnych naskórka, więc brodawki szybko nawracają, jeśli wirus nie został wyeliminowany.⁷⁷

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Materiały źródłowe

#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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#2 Warts, verrucas, human papillomavirus infection
https://dermnetnz.org/topics/viral-wart
Warts are due to infection by the human papillomavirus (HPV), a double-stranded DNA virus. There are more than 150 known HPV types, only some of which infect the skin, giving rise to a variety of clinical presentations. Infection begins in the basal layer of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles the wart. The most common HPV types infecting the skin are types 1, 2, 3, 4, 10, 27, 29, and 57. […] HPV is spread by direct skin-to-skin contact or autoinoculation; if a wart is scratched or picked, a wart may develop under the fingernail (subungual wart) or virus may be spread to another area of skin. Autoinoculation of the virus in a scratch can result in a line of warts (pseudo-koebnerisation) The incubation period can be as long as twelve months, depending on the amount of virus inoculated. […] Treatments do not kill the virus, but work by removing virus-containing skin. Persistence with the treatment and patience is essential! Remember HPV infects the basal cell layer of the epidermis so warts recur rapidly if the virus has not been eradicated.
#3 Pathology Outlines – Warts (verrucae)
https://www.pathologyoutlines.com/topic/skinnontumorwarts.html
Common viral infection of skin and mucosal epithelial cells (Ann Ig 2018;30:28) […] Caused by human papilloma virus (HPV) (Ann Ig 2018;30:28) […] Spread via direct contact (sexual, skin to skin / fomite) […] HPV invades the epidermal basal cells through microabrasions; induces hyperplasia and hyperkeratosis […] E6 and E7 HPV proteins hijack the checkpoint mechanisms of the cell cycle â uncontrolled proliferation […] Viral genome replication with increased levels of the E1, E2, E4 and E5 proteins […] The virions are sloughed off with the dead squamous cells of the host epithelium for further transmission (Front Biosci (Landmark Ed) 2018;23:1587) […] More than 200 types of HPV (J Dtsch Dermatol Ges 2019;17:613) […] Common and plantar warts: usually HPV 1, 2, 4 and 7 (J Dtsch Dermatol Ges 2019;17:613) […] Genital warts: 90% caused by HPV 6 and 11 (Infect Dis Clin North Am 2013;27:765)
#4 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal
https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment
Warts are common viral skin infections, affecting around 7â12% of the population at any one time, and are more common in children. They are caused by the human papilloma virus (HPV), of which there are over 150 genotypically different types; the most common are HPVs 1, 2, 4, 27 and 57, and HPVs 3 and 10 for plane (flat) warts. […] HPV infects the keratinocytes, the most dominant cell type in the epidermis, which results in development of epidermal thickening and hyperkeratinisation. HPV infection is acquired from direct contact, which may be person-to-person or from the environment (e.g. showers and swimming pools; skin penetration increases if the skin is broken or wet). […] HPV infection is associated with squamous cell carcinoma and pre-malignancy. The likelihood of squamous cell carcinoma is increased in mild immunodeficiency and carriers of certain HPV types. HPV types 5 and 8 are also associated with epidermodysplasia verruciformis, an extremely rare skin disorder that results in the growth of scaly macules and papules.
#5 Pathology Outlines – Warts (verrucae)
https://www.pathologyoutlines.com/topic/skinnontumorwarts.html
Common viral infection of skin and mucosal epithelial cells (Ann Ig 2018;30:28) […] Caused by human papilloma virus (HPV) (Ann Ig 2018;30:28) […] Spread via direct contact (sexual, skin to skin / fomite) […] HPV invades the epidermal basal cells through microabrasions; induces hyperplasia and hyperkeratosis […] E6 and E7 HPV proteins hijack the checkpoint mechanisms of the cell cycle â uncontrolled proliferation […] Viral genome replication with increased levels of the E1, E2, E4 and E5 proteins […] The virions are sloughed off with the dead squamous cells of the host epithelium for further transmission (Front Biosci (Landmark Ed) 2018;23:1587) […] More than 200 types of HPV (J Dtsch Dermatol Ges 2019;17:613) […] Common and plantar warts: usually HPV 1, 2, 4 and 7 (J Dtsch Dermatol Ges 2019;17:613) […] Genital warts: 90% caused by HPV 6 and 11 (Infect Dis Clin North Am 2013;27:765)
#6 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Currently, more than 100 types of HPV have been identified. Certain HPV types tend to infect skin at particular anatomic sites; however, warts of any HPV type may occur at any site. The primary clinical manifestations of HPV infection include common warts, genital warts, flat warts, and deep palmoplantar warts (myrmecia). Less common manifestations of HPV infection include focal epithelial hyperplasia (Heck disease), epidermodysplasia verruciformis, and plantar cysts. Warts are transmitted by direct or indirect contact, and predisposing factors include disruption to the normal epithelial barrier. […] Warts can affect any area on the skin and mucous membranes. The HPV virus infects the epithelium, and systemic dissemination of the virus does not occur. Viral replication occurs in differentiated epithelial cells in the upper level of the epidermis; however, viral particles can be found in the basal layer.
#7 Plantar wart – Wikipedia
https://en.wikipedia.org/wiki/Plantar_wart
Plantar warts are benign epithelial tumors generally caused by infection by human papillomavirus types 1, 2, 4, 60, or 63, but also by types 57, 65, 66, and 156. […] The virus attacks compromised skin through direct contact, possibly entering through tiny cuts and abrasions in the stratum corneum (outermost layer of skin). […] Warts may spread through autoinoculation, by infecting nearby skin, or by contaminated walking surfaces.
#8 Plantar warts – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/plantar-warts/symptoms-causes/syc-20352691
Plantar warts are caused by the same type of virus that causes warts on your hands and fingers. But, because of their location, they can be painful. […] Plantar warts are caused by HPV. This virus enters through tiny cuts or breaks on the bottom of the feet. […] Plantar warts are caused by an infection with HPV in the outer layer of skin on the soles of the feet. The warts develop when the virus enters through tiny cuts, breaks or weak spots on the bottom of the foot. […] HPV is very common, and more than 100 kinds of the virus exist. But only a few of them cause warts on the feet. Other types of HPV are more likely to cause warts on other areas of your skin or on mucous membranes. […] The HPV strains that cause plantar warts aren’t highly contagious. So the virus isn’t easily spread by direct contact from one person to another. But it thrives in warm, moist places, so you might get the virus by walking barefoot around swimming pools or locker rooms. If the virus spreads from the first site of infection, more warts may grow.
#9 Verruca – Overview | Guy’s and St Thomas’ NHS Foundation Trust
https://www.guysandstthomas.nhs.uk/health-information/verruca
A verruca (plantar wart) is a wart on the foot caused by the human papillomavirus (HPV). […] When the skin gets very wet it loses its suppleness and flexibility, which can cause tiny cracks and splits to occur. These breaks in the skin make it easier for the verruca virus to penetrate the skin. This happens through direct skin-to-skin contact, or indirect contact with contaminated surfaces. The verruca virus thrives in warm, moist environments such as swimming pools, changing rooms and bathrooms. […] Most treatments bought from a pharmacy or shop (such as bazuka) contain salicylic acid as their active ingredient. Salicylic acid and other verruca treatments can also destroy healthy skin tissue. So it is important to protect the skin around the verruca. Apply the treatment following the instructions provided on the packaging, but discontinue use if the skin becomes sore. Sometimes rubbing down the hard skin overlying the verruca with an emery board can ease discomfort and help with stimulating the bodys immune response. […] There are more invasive treatment options for treating verruca such as cryotherapy, needling and Swift therapy.
#10 Cutaneous warts (common, plantar, and flat warts) – UpToDate
https://www.uptodate.com/contents/cutaneous-warts-common-plantar-and-flat-warts
Human papillomaviruses (HPVs) infect epithelial tissues of skin and mucous membranes. The most common clinical manifestations of HPV infection are warts (verrucae). There are over 200 distinct HPV subtypes; some tend to infect specific body sites. HPV type 1 commonly infects the soles of the feet and produces plantar warts, while HPV types 6 and 11 infect the anogenital area and cause anogenital warts. […] Infection with human papillomavirus (HPV) occurs by direct skin contact, with maceration or sites of trauma predisposing patients to inoculation. Latent HPV infection also may occur in normal skin. The reservoir for HPV appears to be individuals with clinical or subclinical infection. […] The incubation period is approximately two to six months.
#11
https://step1.medbullets.com/dermatology/112092/cutaneous-warts-verrucae
cutaneus warts, or verrucae, are skin lesions caused by infection with human papillomaviruses (HPVs) […] transmitted through contact with infected skin of mucous membranes […] warts contain high viral load […] virus invades epidermal basal layer through microabrasions and are confined to epidermis […] incubation period is 2-6 months.
#12 Warts and verrucas | nidirect
https://www.nidirect.gov.uk/conditions/warts-and-verrucas
Warts are small, rough growths which are caused by certain strains of the human papilloma virus (HPV). […] Warts and verrucas can be spread to other people through close skin contact or contact with contaminated objects or surfaces, such as: towels, shoes and socks, areas surrounding swimming pools, floors of communal changing areas. […] After becoming infected, it can take weeks or even months for a wart or verruca to appear.
#13 Pathology Outlines – Warts (verrucae)
https://www.pathologyoutlines.com/topic/skinnontumorwarts.html
Common viral infection of skin and mucosal epithelial cells (Ann Ig 2018;30:28) […] Caused by human papilloma virus (HPV) (Ann Ig 2018;30:28) […] Spread via direct contact (sexual, skin to skin / fomite) […] HPV invades the epidermal basal cells through microabrasions; induces hyperplasia and hyperkeratosis […] E6 and E7 HPV proteins hijack the checkpoint mechanisms of the cell cycle â uncontrolled proliferation […] Viral genome replication with increased levels of the E1, E2, E4 and E5 proteins […] The virions are sloughed off with the dead squamous cells of the host epithelium for further transmission (Front Biosci (Landmark Ed) 2018;23:1587) […] More than 200 types of HPV (J Dtsch Dermatol Ges 2019;17:613) […] Common and plantar warts: usually HPV 1, 2, 4 and 7 (J Dtsch Dermatol Ges 2019;17:613) […] Genital warts: 90% caused by HPV 6 and 11 (Infect Dis Clin North Am 2013;27:765)
#14 Pathology Outlines – Warts (verrucae)
https://www.pathologyoutlines.com/topic/skinnontumorwarts.html
Common viral infection of skin and mucosal epithelial cells (Ann Ig 2018;30:28) […] Caused by human papilloma virus (HPV) (Ann Ig 2018;30:28) […] Spread via direct contact (sexual, skin to skin / fomite) […] HPV invades the epidermal basal cells through microabrasions; induces hyperplasia and hyperkeratosis […] E6 and E7 HPV proteins hijack the checkpoint mechanisms of the cell cycle â uncontrolled proliferation […] Viral genome replication with increased levels of the E1, E2, E4 and E5 proteins […] The virions are sloughed off with the dead squamous cells of the host epithelium for further transmission (Front Biosci (Landmark Ed) 2018;23:1587) […] More than 200 types of HPV (J Dtsch Dermatol Ges 2019;17:613) […] Common and plantar warts: usually HPV 1, 2, 4 and 7 (J Dtsch Dermatol Ges 2019;17:613) […] Genital warts: 90% caused by HPV 6 and 11 (Infect Dis Clin North Am 2013;27:765)
#15 Pathology Outlines – Warts (verrucae)
https://www.pathologyoutlines.com/topic/skinnontumorwarts.html
Common viral infection of skin and mucosal epithelial cells (Ann Ig 2018;30:28) […] Caused by human papilloma virus (HPV) (Ann Ig 2018;30:28) […] Spread via direct contact (sexual, skin to skin / fomite) […] HPV invades the epidermal basal cells through microabrasions; induces hyperplasia and hyperkeratosis […] E6 and E7 HPV proteins hijack the checkpoint mechanisms of the cell cycle â uncontrolled proliferation […] Viral genome replication with increased levels of the E1, E2, E4 and E5 proteins […] The virions are sloughed off with the dead squamous cells of the host epithelium for further transmission (Front Biosci (Landmark Ed) 2018;23:1587) […] More than 200 types of HPV (J Dtsch Dermatol Ges 2019;17:613) […] Common and plantar warts: usually HPV 1, 2, 4 and 7 (J Dtsch Dermatol Ges 2019;17:613) […] Genital warts: 90% caused by HPV 6 and 11 (Infect Dis Clin North Am 2013;27:765)
#16 Warts: Causes, types, and treatments
https://www.medicalnewstoday.com/articles/155039
The human papillomavirus (HPV) family causes warts. These growths can appear anywhere on the body and are transmissible through touch. There are more than 100 types of HPV. […] HPV causes the excessive and rapid growth of keratin, which is a hard protein on the top layer of the skin. This results in warts forming. […] Different HPV strains cause different warts. These strains can transmit through close skin-to-skin contact and contact with items recently exposed to HPV. […] The virus can spread to other parts of the body through scratching or biting a wart. […] People with a compromised or suppressed immune system have a higher risk for contracting an HPV strain leading to warts. […] Some strains of HPV can cause warts on, in, or around the genitals. […] Warts occur when an HPV strain infects the skin and causes rapid cell growth.
#17 Warts and verrucas: assessment and treatment – The Pharmaceutical Journal
https://pharmaceutical-journal.com/article/ld/warts-and-verrucas-assessment-and-treatment
Warts are common viral skin infections, affecting around 7â12% of the population at any one time, and are more common in children. They are caused by the human papilloma virus (HPV), of which there are over 150 genotypically different types; the most common are HPVs 1, 2, 4, 27 and 57, and HPVs 3 and 10 for plane (flat) warts. […] HPV infects the keratinocytes, the most dominant cell type in the epidermis, which results in development of epidermal thickening and hyperkeratinisation. HPV infection is acquired from direct contact, which may be person-to-person or from the environment (e.g. showers and swimming pools; skin penetration increases if the skin is broken or wet). […] HPV infection is associated with squamous cell carcinoma and pre-malignancy. The likelihood of squamous cell carcinoma is increased in mild immunodeficiency and carriers of certain HPV types. HPV types 5 and 8 are also associated with epidermodysplasia verruciformis, an extremely rare skin disorder that results in the growth of scaly macules and papules.
#18 Verruca vulgaris (common wart) pathology
https://dermnetnz.org/topics/verruca-vulgaris-pathology
Verruca vulgaris (common viral wart) is a keratotic lesion caused by specific human papillomavirus (HPV) types. […] Histopathologic examination of verruca vulgaris reveals a markedly papillomatous epidermis with hypergranulomatosis and overlying tiers of parakeratosis. […] Characteristic vacuolated keratinocytes (koilocytes), which have a small shrunken nucleus surrounded by a perinuclear halos, are seen in the upper epidermis. […] Special stains are not required to make the diagnosis. PCR may be used to identify the HPV type.
#19 Wart – Wikipedia
https://en.wikipedia.org/wiki/Wart
Warts are caused by the human papillomavirus (HPV). […] HPV infects the squamous epithelium, usually of the skin or genitals, but each HPV type is typically only able to infect a few specific areas of the body. Many HPV types can produce a benign growth, often called a „wart” or „papilloma”, in the area they infect. […] Common warts have a characteristic appearance under the microscope. They have thickening of the stratum corneum (hyperkeratosis), thickening of the stratum spinosum (acanthosis), thickening of the stratum granulosum, rete ridge elongation, and large blood vessels at the dermoepidermal junction. […] The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen. […] The virus is resistant to drying and heat, but killed by 100 C (212 F) temperature and ultraviolet radiation.
#20 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). […] Plantar warts shed HPV, which can then infect other sites in the plantar region or spread to other people. […] Once a plantar wart is established, it sheds HPV via desquamated epithelial cells. The viral particles can subsequently infect other sites and hosts. […] After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Once viral DNA copies are sufficient, L1 and L2 viral coat proteins are expressed by surface keratinocytes.
#21 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
The infectious viral particles can then be released in high numbers from desquamated keratinocytes on the surface of the plantar wart to infect other sites or hosts. […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle. […] This response should lead to eradication of the infection and prevent a plantar wart from occurring or lead to regression of established plantar warts. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] The longer the plantar wart remains established, the greater its ability to transmit infection and cause pain and embarrassment.
#22 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
The infectious viral particles can then be released in high numbers from desquamated keratinocytes on the surface of the plantar wart to infect other sites or hosts. […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle. […] This response should lead to eradication of the infection and prevent a plantar wart from occurring or lead to regression of established plantar warts. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] The longer the plantar wart remains established, the greater its ability to transmit infection and cause pain and embarrassment.
#23 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
The infectious viral particles can then be released in high numbers from desquamated keratinocytes on the surface of the plantar wart to infect other sites or hosts. […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle. […] This response should lead to eradication of the infection and prevent a plantar wart from occurring or lead to regression of established plantar warts. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] The longer the plantar wart remains established, the greater its ability to transmit infection and cause pain and embarrassment.
#24 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
The infectious viral particles can then be released in high numbers from desquamated keratinocytes on the surface of the plantar wart to infect other sites or hosts. […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle. […] This response should lead to eradication of the infection and prevent a plantar wart from occurring or lead to regression of established plantar warts. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] The longer the plantar wart remains established, the greater its ability to transmit infection and cause pain and embarrassment.
#25 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Treatment should be considered for warts that are cosmetically unacceptable, in locations that interfere with function, or painful. Patients should be motivated to adhere to treatment, which may require a prolonged course and can be unsuccessful. Treatments are less successful in immunocompromised patients.
#26 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Treatment should be considered for warts that are cosmetically unacceptable, in locations that interfere with function, or painful. Patients should be motivated to adhere to treatment, which may require a prolonged course and can be unsuccessful. Treatments are less successful in immunocompromised patients.
#27 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
The infectious viral particles can then be released in high numbers from desquamated keratinocytes on the surface of the plantar wart to infect other sites or hosts. […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle. […] This response should lead to eradication of the infection and prevent a plantar wart from occurring or lead to regression of established plantar warts. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] The longer the plantar wart remains established, the greater its ability to transmit infection and cause pain and embarrassment.
#28 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Treatment should be considered for warts that are cosmetically unacceptable, in locations that interfere with function, or painful. Patients should be motivated to adhere to treatment, which may require a prolonged course and can be unsuccessful. Treatments are less successful in immunocompromised patients.
#29 Common Wart (Verruca vulgaris)
https://www.webpathology.com/images/dermpath/non-neoplastic-dermpath—ii/skin-infections—viral/41296
HPV lesions are generally self-limited but can persist for several years. They eventually regress in most cases due to cell-mediated immunity. Regression is associated with basal cell degeneration, epidermal degeneration, and vascular thrombosis. […] Patients with defective cell-mediated immunity (primary, iatrogenic, or HIV-induced) are particularly at risk for developing large crops of warts that don’t regress spontaneously and are difficult to treat.
#30 Warts and Verrucas, symptoms, prevention, mechanisms and treatment
https://bodytonicclinic.co.uk/warts-and-verrucas/
The altered cells replicate and then migrate to the surface, proliferating and altering the epidermis. Swollen cells create a hard lesion, which presses on the surrounding tissue and the dermis itself causing pain and micro-bleeding into the epidermis (hence we can often spot black dots on the tumour). […] Since HPV activates anti-inflammatory T suppressor cells and changes Langerhan cell function, the immune system does not detect it and can therefore not fight it off. […] The spread of the lesion is impossible to predict as it depends, among other factors, on the individualâs susceptibility to the virus.
#31 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Currently, more than 100 types of HPV have been identified. Certain HPV types tend to infect skin at particular anatomic sites; however, warts of any HPV type may occur at any site. The primary clinical manifestations of HPV infection include common warts, genital warts, flat warts, and deep palmoplantar warts (myrmecia). Less common manifestations of HPV infection include focal epithelial hyperplasia (Heck disease), epidermodysplasia verruciformis, and plantar cysts. Warts are transmitted by direct or indirect contact, and predisposing factors include disruption to the normal epithelial barrier. […] Warts can affect any area on the skin and mucous membranes. The HPV virus infects the epithelium, and systemic dissemination of the virus does not occur. Viral replication occurs in differentiated epithelial cells in the upper level of the epidermis; however, viral particles can be found in the basal layer.
#32 Warts, verrucas, human papillomavirus infection
https://dermnetnz.org/topics/viral-wart
Warts are due to infection by the human papillomavirus (HPV), a double-stranded DNA virus. There are more than 150 known HPV types, only some of which infect the skin, giving rise to a variety of clinical presentations. Infection begins in the basal layer of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles the wart. The most common HPV types infecting the skin are types 1, 2, 3, 4, 10, 27, 29, and 57. […] HPV is spread by direct skin-to-skin contact or autoinoculation; if a wart is scratched or picked, a wart may develop under the fingernail (subungual wart) or virus may be spread to another area of skin. Autoinoculation of the virus in a scratch can result in a line of warts (pseudo-koebnerisation) The incubation period can be as long as twelve months, depending on the amount of virus inoculated. […] Treatments do not kill the virus, but work by removing virus-containing skin. Persistence with the treatment and patience is essential! Remember HPV infects the basal cell layer of the epidermis so warts recur rapidly if the virus has not been eradicated.
#33 Warts and verrucas
https://www.nhs.uk/conditions/warts-and-verrucas/
Warts and verrucas are caused by a virus. They can be spread to other people from contaminated surfaces or through close skin contact. […] It can take months for a wart or verruca to appear after contact with the virus.
#34 Wart – Wikipedia
https://en.wikipedia.org/wiki/Wart
Warts are caused by the human papillomavirus (HPV). […] HPV infects the squamous epithelium, usually of the skin or genitals, but each HPV type is typically only able to infect a few specific areas of the body. Many HPV types can produce a benign growth, often called a „wart” or „papilloma”, in the area they infect. […] Common warts have a characteristic appearance under the microscope. They have thickening of the stratum corneum (hyperkeratosis), thickening of the stratum spinosum (acanthosis), thickening of the stratum granulosum, rete ridge elongation, and large blood vessels at the dermoepidermal junction. […] The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen. […] The virus is resistant to drying and heat, but killed by 100 C (212 F) temperature and ultraviolet radiation.
#35 Wart – Wikipedia
https://en.wikipedia.org/wiki/Wart
Warts are caused by the human papillomavirus (HPV). […] HPV infects the squamous epithelium, usually of the skin or genitals, but each HPV type is typically only able to infect a few specific areas of the body. Many HPV types can produce a benign growth, often called a „wart” or „papilloma”, in the area they infect. […] Common warts have a characteristic appearance under the microscope. They have thickening of the stratum corneum (hyperkeratosis), thickening of the stratum spinosum (acanthosis), thickening of the stratum granulosum, rete ridge elongation, and large blood vessels at the dermoepidermal junction. […] The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen. […] The virus is resistant to drying and heat, but killed by 100 C (212 F) temperature and ultraviolet radiation.
#36 Warts/Verrucas Causes and Treatment Medical Consultations Online
https://medicalconsultationsonline.co.uk/product/warts-verrucas-causes-and-treatment/
Warts are generally harmless, and they occur due to the human papillomavirus (HPV). […] Although you need close skin-to-skin contact to transfer the virus, it can also be spread by contact with an already contaminated surface. […] Factors that increase the risk of developing warts/verrucas include: Direct contact: Warts/verrucas are contagious and can spread from person to person through direct contact with the virus. […] A weakened immune system makes it harder for the body to fight off the HPV virus, increasing the likelihood of developing warts/verrucas. […] HPV thrives in warm, moist environments, which is why verrucas are commonly found on the soles of the feet. […] Any damage to the skin, such as cuts, scrapes, or punctures, creates an entry point for the HPV virus. […] Poor personal hygiene can increase the risk of verruca transmission. […] Verrucas are more common in children and adolescents, possibly because their immune systems are still developing and they are more likely to participate in activities that expose them to the virus, such as walking barefoot in communal areas.
#37 Verruca Symptoms, Causes & Treatments | Spire Healthcare
https://www.spirehealthcare.com/conditions/verruca/
A verruca is caused by the human papillomavirus (HPV). There are numerous strains of the virus but verrucas are only caused by HPV types 1, 2, 4, 27 and 57. The viral infection affects the epithelial cells in the skin of the foot, making them over-grow and thicken, causing small rough lumps known as papules. […] HPV isn’t highly contagious, however, a wet environment can make the spread of infection easier. The virus can be spread through contact between bare feet and HPV-contaminated surfaces in changing rooms and shower cubicles. The virus can even survive outside the body for over a year. […] You’re also more likely to get a verruca if you are immunosuppressed. This may be because you’re receiving immunosuppressants due to a transplant or another condition, or receiving treatment that can weaken your immune system such as chemotherapy. Having a condition which weakens your immune system such as some blood cancers or AIDS will also increase your risk of verrucas.
#38 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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#39 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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#40 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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#41 Warts and verrucas | Healthify
https://healthify.nz/health-a-z/w/warts-and-verrucas/
Warts are caused by different strains of the human papillomavirus (HPV). […] Warts happen when HPV virus infects the top layer of your skin and causes your skin cells to grow very fast. […] The strains of HPV that cause harmless warts on your hands, legs or feet are different to those that cause genital warts and cervical cancer.
#42 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). […] The human papillomavirus (HPV) causes warts. There are over 100 subtypes (strains) of HPV, but only a few types can cause warts on certain parts of your body. […] Certain strains of the human papillomavirus (HPV) cause warts. The virus can enter your skin through small cuts and cause extra cell growth. The outer layer of your skin turns thicker and harder, forming a wart. Warts are more likely to infect moist and soft skin or injured skin. […] All warts come from HPV, but not all forms of HPV cause warts. The type of HPV that can progress to cancer (like cervical cancer) doesn’t cause warts.
#43 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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#44 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#45 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. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. HPV may occur at any site. The primary manifestations of HPV infection include common warts, genital warts, flat warts, deep palmoplantar warts (Myrmecia), focal epithelial hyperplasia, Epidermodysplasia verruciformis, and Plantar cysts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. These subtypes include HPV strains 6, 11, 16, 18, 31, and 35. Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. HPV strains 5, 8, 20, and 47 also have malignant potential in individuals with epidermodysplasia verruciformis.
#46 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#47 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Topical irritant treatments have mechanisms of action that involve directing an immune response to the irritant locally, which targets the HPV lesion as well. […] Direct antiviral effects can be achieved with intralesional injection of bleomycin and interferon alfa-2b, but these treatments are reserved for the most recalcitrant warts. […] Many warts regress spontaneously (particularly common warts); others may persist for years and recur at the same or different sites, even with treatment. Factors influencing recurrence appear to be related to the patients overall immune status as well as local factors. […] Genital HPV infection has malignant potential but is rare in HPV-induced skin warts, except among immunosuppressed patients.
#48 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#49 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#50 Verrucas and Swimming | Aquatics GB
https://www.britishswimming.org/members-resources/athletes-and-parents/understanding-verrucas/
Warts on the feet called verrucas have long been seen a nuisance. […] Verrucas, like most warts, are due to a viral infection of the growing layers of the skin. Injury of the skin is a prerequisite for the contraction of warts, and there is a predilection for the hands, knees and feet to be more prone to minor injury during childhood activities. […] With the plantar skin being slightly soggy, together with possibly damp duckboards or foot mats and the skin of the feet being more easily damaged by slight irregularities of the floor, it is easy for the virus to be implanted. […] As with most infection, particularly viral, immunity to the causative (virus) occurs in time. This is possibly why such warts occur less often in adolescents and adults. […] Such an immunity may well be under hormonal control, and while it is probably not as strong or as long lasting as that found in infections such as measles and rubella (German measles), an effective immunity usually exists for a decade or two.
#51 Common Wart (Verruca vulgaris)
https://www.webpathology.com/images/dermpath/non-neoplastic-dermpath—ii/skin-infections—viral/41296
HPV lesions are generally self-limited but can persist for several years. They eventually regress in most cases due to cell-mediated immunity. Regression is associated with basal cell degeneration, epidermal degeneration, and vascular thrombosis. […] Patients with defective cell-mediated immunity (primary, iatrogenic, or HIV-induced) are particularly at risk for developing large crops of warts that don’t regress spontaneously and are difficult to treat.
#52 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#53 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#54 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences. […] Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.
#55 Warts: Pictures, Causes, Types, Removal, and Treatment
https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-warts
Over time, your body will often build up a resistance and fight warts off. But it may take months or as many as 2 years for them to disappear. […] But there’s no cure for HPV, so some of the virus might stay in your skin after the wart is gone and reappear later. […] For stubborn warts, peeling creams with glycolic acid, stronger salicylic acid, or tretinoin could do the trick. Diphencyprone (DCP) and imiquimod (Aldara) irritate your skin to encourage your immune system to go to work there. […] Your doctor may use a needle to put medicine into the wart to help get rid of it. Bleomycin, a cancer drug, may stop infected cells from making more. Interferon boosts your immune system to better fight the HPV, typically for genital warts.
#56 Warts and Verrucas, symptoms, prevention, mechanisms and treatment
https://bodytonicclinic.co.uk/warts-and-verrucas/
A verruca is one of the most common viral infections presented not only on the feet, but also on different parts of the body. […] It is a benign tumour, which is caused by infection of epidermal keratinocytes double stranded DNA Human Papilloma Virus (HPV). The research shows that there are between 100 and 200 different types of plantar warts, each caused by a different subtype of HPV. […] Once the virus gets into the body it will stay there for a lifetime, hence there is no guarantee that once cleared it will not appear again. Usually, it takes between 1 to 8 months to develop a verruca. Every time the individualâs immune system is suppressed (for any reason) it can trigger the HPV to activate. […] The virus affects the outermost layer of the skin, the epidermis, by replicating and changing the structure of the cells filling them with fluid. In the stratum spinosum of the epidermis, the number of cells increases, this process is known as hyperplasia. This can result in an increased localised bulk of tissue within the skin.
#57 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Topical irritant treatments have mechanisms of action that involve directing an immune response to the irritant locally, which targets the HPV lesion as well. […] Direct antiviral effects can be achieved with intralesional injection of bleomycin and interferon alfa-2b, but these treatments are reserved for the most recalcitrant warts. […] Many warts regress spontaneously (particularly common warts); others may persist for years and recur at the same or different sites, even with treatment. Factors influencing recurrence appear to be related to the patients overall immune status as well as local factors. […] Genital HPV infection has malignant potential but is rare in HPV-induced skin warts, except among immunosuppressed patients.
#58 Oral Acyclovir in the Treatment of Verruca – JDDonline – Journal of Drugs in Dermatology
https://jddonline.com/articles/oral-acyclovir-in-the-treatment-of-verruca-S1545961616P0237X
Verruca (plantar warts) are a common problem caused by the human papilloma virus (HPV) that can be irritating and painful. Current treatment of verruca is limited to traditional therapies that are quantified by two distinct mechanistic activities either destructive or immunomodulating. Destructive therapies can be further segregated into those that are topical pharmacologic in nature (eg, salicylic acid, monochloroacetic acid) or physical (eg, surgery, cryotherapy). Susceptibility of HPV to antivirals is not possible as HPV is not conducive to being cultured in vitro. […] Acyclovir is a synthetic purine nucleoside analogue with activity against herpes simplex virus type 1 (HSV-1), 2 (HSV-2), and varicella-zoster virus (VZV). Acyclovir uses viral thymidine kinase to convert to acyclovir monophosphate, a nucleotide analogue that is eventually converted to its active form of acyclovir triphosphate. Through this mechanism of utilizing viral thymidine kinase to convert to its active form, acyclovir specifically targets viral DNA, preventing replication of the herpes virus in the host. […] There remains a paucity of data to support the use of oral acyclovir which achieves systematic concentrations in the body, for the treatment of verruca.
#59 Oral Acyclovir in the Treatment of Verruca – JDDonline – Journal of Drugs in Dermatology
https://jddonline.com/articles/oral-acyclovir-in-the-treatment-of-verruca-S1545961616P0237X
Verruca (plantar warts) are a common problem caused by the human papilloma virus (HPV) that can be irritating and painful. Current treatment of verruca is limited to traditional therapies that are quantified by two distinct mechanistic activities either destructive or immunomodulating. Destructive therapies can be further segregated into those that are topical pharmacologic in nature (eg, salicylic acid, monochloroacetic acid) or physical (eg, surgery, cryotherapy). Susceptibility of HPV to antivirals is not possible as HPV is not conducive to being cultured in vitro. […] Acyclovir is a synthetic purine nucleoside analogue with activity against herpes simplex virus type 1 (HSV-1), 2 (HSV-2), and varicella-zoster virus (VZV). Acyclovir uses viral thymidine kinase to convert to acyclovir monophosphate, a nucleotide analogue that is eventually converted to its active form of acyclovir triphosphate. Through this mechanism of utilizing viral thymidine kinase to convert to its active form, acyclovir specifically targets viral DNA, preventing replication of the herpes virus in the host. […] There remains a paucity of data to support the use of oral acyclovir which achieves systematic concentrations in the body, for the treatment of verruca.
#60 Salicylic acid wart removal: Effectiveness and how to use
https://www.medicalnewstoday.com/articles/324732
Warts occur when a virus causes skin cells to multiply faster than usual, creating a raised skin area. […] Salicylic acid peels the skin away in layers, which removes the wart over time. The acid also irritates the wart area, encouraging the immune system to respond to the virus. […] Different factors, such as the thickness of the wart, its location on the body, and individual immune systems, can affect the success of wart treatment. […] These drugs stimulate the immune system to respond and treat the wart. […] These drugs can trigger the immune system to fight the wart.
#61 Warts and Verrucas: Causes and Treatment
https://patient.info/skin-conditions/warts-and-verrucas-leaflet
Warts are caused by a virus (human papillomavirus) which causes a reaction in the skin. […] Warts and verrucas usually clear in time without treatment. […] The most commonly used treatments are: Salicylic acid and Freezing treatment. […] Salicylic acid burns off the top layer of the wart. […] Freezing and thawing destroys the wart tissue. […] Verruca needling works by stimulating your own body’s immune response to fight off the virus. […] Swift microwave therapy uses precise doses of microwave energy delivered directly through a probe, heating and destroying the verruca.
#62 Human Papillomavirus (HPV) Infection – STI Treatment Guidelines
https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
Cryotherapy is a provider-administered therapy that destroys warts by thermal-induced cytolysis. […] Trichloroacetic acid (TCA) and bichloroacetic acid (BCA) are provider-administered caustic agents that destroy warts by chemical coagulation of proteins. […] Persistent infection with high-risk (oncogenic) types of HPV has a causal role in approximately all cervical cancers and in certain vulvar, vaginal, penile, anal, and oropharyngeal cancers.
#63 Human Papillomavirus (HPV) Infection – STI Treatment Guidelines
https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
Cryotherapy is a provider-administered therapy that destroys warts by thermal-induced cytolysis. […] Trichloroacetic acid (TCA) and bichloroacetic acid (BCA) are provider-administered caustic agents that destroy warts by chemical coagulation of proteins. […] Persistent infection with high-risk (oncogenic) types of HPV has a causal role in approximately all cervical cancers and in certain vulvar, vaginal, penile, anal, and oropharyngeal cancers.
#64 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Topical irritant treatments have mechanisms of action that involve directing an immune response to the irritant locally, which targets the HPV lesion as well. […] Direct antiviral effects can be achieved with intralesional injection of bleomycin and interferon alfa-2b, but these treatments are reserved for the most recalcitrant warts. […] Many warts regress spontaneously (particularly common warts); others may persist for years and recur at the same or different sites, even with treatment. Factors influencing recurrence appear to be related to the patients overall immune status as well as local factors. […] Genital HPV infection has malignant potential but is rare in HPV-induced skin warts, except among immunosuppressed patients.
#65 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Topical irritant treatments have mechanisms of action that involve directing an immune response to the irritant locally, which targets the HPV lesion as well. […] Direct antiviral effects can be achieved with intralesional injection of bleomycin and interferon alfa-2b, but these treatments are reserved for the most recalcitrant warts. […] Many warts regress spontaneously (particularly common warts); others may persist for years and recur at the same or different sites, even with treatment. Factors influencing recurrence appear to be related to the patients overall immune status as well as local factors. […] Genital HPV infection has malignant potential but is rare in HPV-induced skin warts, except among immunosuppressed patients.
#66 Treatment of Warts in Pediatrics: A Review
https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-6-132.php?jid=jfmdp
Cimetidine: Both oral cimetidine and ranitidine are Histamine-2 blockers on suppressor T cells and increase lymphocytic proliferation and the inflammatory response to phagocytose virally infected tissue. […] Imiquimod: Topical 5% imiquimod increases anti-tumor and anti-viral effects by increasing specific cytokines that modulate the immune response. […] Intralesional antigen: Three types of intralesional antigens used for wart treatment are candida, mumps, and trichophyton. These are injected in to the wart to help provoke an intracellular immune response. […] Bacillus Calmette-Guerin (BCG) vaccine: The use of intradermal BCG vaccine elicits a delayed Type IV hypersensitivity response, which attracts T cells to attack HPV in infected cells. […] Zinc allows for regulation of the immune response by increasing phagocytosis and interaction between viral components and host cells.
#67 Treatment of Warts in Pediatrics: A Review
https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-6-132.php?jid=jfmdp
Verruca Vulgaris, also known as common warts, are caused by caused by non-malignant strains of HPV, including: 1, 2, 3, 4, and 57. […] Transmission of verruca vulgaris is via direct skin contact, especially in areas of the body that have breaks in the epithelium. […] The goal of this review is to examine and assess each of the different treatment options. […] Salicylic acid is a topical chemical agent that destroys the epithelial layer infected by the wart. […] Cantharidin is also known as „beetle juice” as it is derived from secretions of blister beetles of the family Meloidae. This substance causes destruction of epithelial cells by generating a blister formation around the affected area. […] Contact allergens: The two types of contact allergen therapy used for treatment of refractory warts are diphenylcyclopropenone (DPCP) and Squaric Acid Dibutylester (SADBE). These agents induce a type IV hypersensitivity reaction, so treatments require initial sensitization.
#68 Warts and Verrucas: Causes and Treatment
https://patient.info/skin-conditions/warts-and-verrucas-leaflet
Warts are caused by a virus (human papillomavirus) which causes a reaction in the skin. […] Warts and verrucas usually clear in time without treatment. […] The most commonly used treatments are: Salicylic acid and Freezing treatment. […] Salicylic acid burns off the top layer of the wart. […] Freezing and thawing destroys the wart tissue. […] Verruca needling works by stimulating your own body’s immune response to fight off the virus. […] Swift microwave therapy uses precise doses of microwave energy delivered directly through a probe, heating and destroying the verruca.
#69 Verruca Symptoms, Causes & Treatments | Spire Healthcare
https://www.spirehealthcare.com/conditions/verruca/
In some cases, your GP may suggest combining salicylic acid medication with cryotherapy and a number of studies have shown this to be particularly effective. This is where you apply salicylic acid to the verruca in between cryotherapy treatments – unless there’s blistering. […] Other possible treatments for verrucas include: Verruca needling stimulating the body’s immune response to the virus by puncturing the verruca to cause bleeding under local anaesthetic.
#70 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Topical irritant treatments have mechanisms of action that involve directing an immune response to the irritant locally, which targets the HPV lesion as well. […] Direct antiviral effects can be achieved with intralesional injection of bleomycin and interferon alfa-2b, but these treatments are reserved for the most recalcitrant warts. […] Many warts regress spontaneously (particularly common warts); others may persist for years and recur at the same or different sites, even with treatment. Factors influencing recurrence appear to be related to the patients overall immune status as well as local factors. […] Genital HPV infection has malignant potential but is rare in HPV-induced skin warts, except among immunosuppressed patients.
#71 Treatment of Warts in Pediatrics: A Review
https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-6-132.php?jid=jfmdp
Cimetidine: Both oral cimetidine and ranitidine are Histamine-2 blockers on suppressor T cells and increase lymphocytic proliferation and the inflammatory response to phagocytose virally infected tissue. […] Imiquimod: Topical 5% imiquimod increases anti-tumor and anti-viral effects by increasing specific cytokines that modulate the immune response. […] Intralesional antigen: Three types of intralesional antigens used for wart treatment are candida, mumps, and trichophyton. These are injected in to the wart to help provoke an intracellular immune response. […] Bacillus Calmette-Guerin (BCG) vaccine: The use of intradermal BCG vaccine elicits a delayed Type IV hypersensitivity response, which attracts T cells to attack HPV in infected cells. […] Zinc allows for regulation of the immune response by increasing phagocytosis and interaction between viral components and host cells.
#72 Warts and Verrucas: Causes and Treatment
https://patient.info/skin-conditions/warts-and-verrucas-leaflet
Warts are caused by a virus (human papillomavirus) which causes a reaction in the skin. […] Warts and verrucas usually clear in time without treatment. […] The most commonly used treatments are: Salicylic acid and Freezing treatment. […] Salicylic acid burns off the top layer of the wart. […] Freezing and thawing destroys the wart tissue. […] Verruca needling works by stimulating your own body’s immune response to fight off the virus. […] Swift microwave therapy uses precise doses of microwave energy delivered directly through a probe, heating and destroying the verruca.
#73 Warts & Verrucae Treatment Reading – Causes, Symptoms | Derma
https://www.dermareading.co.uk/warts-and-verrucae
The latest and most effective treatment for most warts is using Swift Microwave Treatment, which uses microwaves to treat the underlying HPV. […] Cryotherapy or freezing is often successful in treating a wart, and topical wart paints might also be suitable. In rare cases, it might be appropriate to undergo a minor surgery called excision to remove a wart.
#74 Treatment of Warts in Pediatrics: A Review
https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-6-132.php?jid=jfmdp
Verruca Vulgaris, also known as common warts, are caused by caused by non-malignant strains of HPV, including: 1, 2, 3, 4, and 57. […] Transmission of verruca vulgaris is via direct skin contact, especially in areas of the body that have breaks in the epithelium. […] The goal of this review is to examine and assess each of the different treatment options. […] Salicylic acid is a topical chemical agent that destroys the epithelial layer infected by the wart. […] Cantharidin is also known as „beetle juice” as it is derived from secretions of blister beetles of the family Meloidae. This substance causes destruction of epithelial cells by generating a blister formation around the affected area. […] Contact allergens: The two types of contact allergen therapy used for treatment of refractory warts are diphenylcyclopropenone (DPCP) and Squaric Acid Dibutylester (SADBE). These agents induce a type IV hypersensitivity reaction, so treatments require initial sensitization.
#75 Plantar Warts (Verruca Pedis) – Ankle, Foot and Orthotic Centre
https://ankleandfootcentre.com.au/plantar-warts-verruca-pedis/
A plantar wart also known as a verruca, Papiloma, or verruca pedis is a skin condition that is caused by a virus (the Human Papiloma Virus). […] When the virus infects the skin it hijacks the normal basement cells and causes them to reproduce abnormally. The body does not realise there is a virus and the wart goes undetected. […] The viral cells cause an exaggeration of the dermal epidermal junction, reduce the normal striations of the skin and draw in blood vessels resulting in there appearing to be black dots on the surface of the wart. […] The virus needs to enter the skin and infect the basement epithelial cells. […] The skin is usually a strong barrier against viral infections but certain factors reduce the effectiveness of the skin these include: Feet being excessively wet and coming into contact with the virus (Pool or public showers) and Reduced immunity. […] Cantharidine causes a blister to form on the wart or growth. This action lifts the wart off the skin. The action of cantharidine does not go beyond the epidermal cells and the basal layer remains intact (therefore no scarring).
#76 Salicylic acid wart removal: Effectiveness and how to use
https://www.medicalnewstoday.com/articles/324732
Warts occur when a virus causes skin cells to multiply faster than usual, creating a raised skin area. […] Salicylic acid peels the skin away in layers, which removes the wart over time. The acid also irritates the wart area, encouraging the immune system to respond to the virus. […] Different factors, such as the thickness of the wart, its location on the body, and individual immune systems, can affect the success of wart treatment. […] These drugs stimulate the immune system to respond and treat the wart. […] These drugs can trigger the immune system to fight the wart.
#77 Warts, verrucas, human papillomavirus infection
https://dermnetnz.org/topics/viral-wart
Warts are due to infection by the human papillomavirus (HPV), a double-stranded DNA virus. There are more than 150 known HPV types, only some of which infect the skin, giving rise to a variety of clinical presentations. Infection begins in the basal layer of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles the wart. The most common HPV types infecting the skin are types 1, 2, 3, 4, 10, 27, 29, and 57. […] HPV is spread by direct skin-to-skin contact or autoinoculation; if a wart is scratched or picked, a wart may develop under the fingernail (subungual wart) or virus may be spread to another area of skin. Autoinoculation of the virus in a scratch can result in a line of warts (pseudo-koebnerisation) The incubation period can be as long as twelve months, depending on the amount of virus inoculated. […] Treatments do not kill the virus, but work by removing virus-containing skin. Persistence with the treatment and patience is essential! Remember HPV infects the basal cell layer of the epidermis so warts recur rapidly if the virus has not been eradicated.