Materiały źródłowe

• #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.

• #2 Warts: Diagnosis and treatment

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

  How do dermatologists diagnose warts? Your dermatologist can usually diagnose warts by looking at them. […] If a wart is growing rapidly, looks like an open sore, or fails to clear with treatment, your dermatologist may perform a skin biopsy. During this procedure, your dermatologist numbs the area and removes a sample from the growth. This procedure can be done in the office while you’re awake. […] A skin biopsy can tell your dermatologist if you have a wart or another skin condition.

• #3 Common warts – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/common-warts/symptoms-causes/syc-20371125

  Common warts are small, grainy skin growths that occur most often on the fingers or hands. They’re rough to the touch and often have tiny black dots. These dots are clotted blood vessels. […] See a healthcare professional for common warts if: […] You’ve tried treating the warts, but they persist, spread or come back. […] You’re unsure whether the growths are warts. […] Common warts are caused by the human papillomavirus, also called HPV. […] Each person’s immune system responds to HPV differently. So not everyone who comes in contact with HPV develops warts. […] People at higher risk of developing common warts include: […] Diagnosis treatment.

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

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

  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. Shaving is typically performed without anesthesia. […] If necessary, confirm the diagnosis of a wart by shaving its surface to reveal thrombosed capillaries in the form of black dots.

• #5 Common warts – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/615

  Common warts should be distinguished from serious conditions that mimic them, such as squamous cell carcinoma, especially in immunocompromised patients. […] Key diagnostic factors include presence of risk factors, lesion growth over weeks to months, round, raised papule, and tiny black dots on surface of lesion. […] Investigations to consider include skin biopsy, immunoperoxidase stain, and skin culture.

• #6 Cutaneous warts – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cutaneous-warts/

  Diagnosis is typically clinical. […] Dermoscopy can show red, brown, or black dots. […] Shaving the surface of the wart causes bleeding. […] Consider biopsy if there is diagnostic uncertainty.

• #7 Warts, verrucas, human papillomavirus infection

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

  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.

• #8 Wart – Wikipedia

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

  On dermatoscopic examination, warts will commonly have fingerlike or knoblike extensions. […] 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.

• #9 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 evidence-based 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. A 35% acetowhite test is suggested in the diagnosis of HPV infection in the genital mucosa. Viral warts are generally diagnosed by visual recognition. However, the identification of atypical skin lesions should be evaluated by pathological examination and HPV genotype testing. For early genital mucosa viral warts, the application of 35% acetic acid can help in the detection of subclinical skin lesions. HPV has more than 200 types and causes multiple diseases including cutaneous and anogenital warts, cervical cancer, and anal cancer in men and women. Understanding the transmission routes of HPV can lead to better prevention for it. Sexual and mother-to-fetus vertical transmissions are the main transmissions route of HPV to cause CA. Virus transmission by skin contact, hand spreading, and contact with underwear or inanimate objects are responsible for common warts, plane warts, and plantar warts. Acetowhite test is recommended for the diagnosis of subclinical CA. In cases where identification of HPV types is required, noninvasive sampling by skin swabbing is recommended for HPV testing, resection or clamping of the warty tissue may be necessary in the case. Dermoscopy may aid in the diagnosis of viral warts. For vulvar CA harboring high-risk HPVs, cervical HPV test is suggested. The primary goal of treatment is to remove warts and improve the presenting symptoms. According to the published guidelines, most patients’ warts disappear after treatment while the recurrences are frequent. Genital warts may heal, remain unchanged, or increase in number and size in untreated patients. Treatment may weaken the infectivity of HPV, but may not necessarily eradicate HPV. 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. Recurrent warts are defined as warts that appear near the original site of warts, which have been completely cleared. The intermediateterm recurrence of warts is 4 months by the end of treatment, and the long-term recurrence is 12 months by the end of treatment. Refractory warts are defined as warts that last for at least 2 years with poor response to more than two traditional treatment options. Local injections with bleomycin, 5-Fluorouracil (5FU), and cidofovir are suggested for refractory and recurrent common warts. Local adverse reactions of intralesional injection therapy include pain, burning, itching, erythema during the procedures, and post-inflammatory pigmentation. Cryotherapy is recommended for common warts. However, patients receiving cryotherapy need to tolerate treatment-related pain and may experience other side effects, such as post-treatment scarring and hyper/hypopigmentation. 10% 5-aminolevulinic acid photodynamic therapy (5ALA-PDT) is recommended for the treatment of flat warts. Lasers and photodynamic therapy could be used to treat multiple flat warts. Local hyperthermia is suggested for patients with plantar warts. Local injections of bleomycin are recommended for the treatment of plantar warts. Podophyllotoxin and imiquimod are not recommended for CA during pregnancy, but trichloroacetic acid can be used. CA during pregnancy could be treated by liquid nitrogen cryotherapy or surgery. Cesarean section is recommended when large warts may block the birth canal or cause massive bleeding.

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

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

  To diagnose this condition, your doctor will do the following: […] 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. […] If you have a vulva, your doctor may also need to perform a pelvic examination, because genital warts can occur deep inside your body. […] If you think you have genital warts, talk with your doctor. They can determine if you have warts and what your best treatment options are.

• #11 Patient education: Common warts, plantar warts, and flat warts (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/common-warts-plantar-warts-and-flat-warts-beyond-the-basics/print

  Skin warts can usually be diagnosed based upon how they look. Skin biopsy or other testing is not usually necessary. […] It is important to see your health care provider if a wart looks odd, grows rapidly, becomes painful, or does not get better with treatment. Skin cancer and other types of skin problems sometimes look similar to warts.

• #12 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. […] Transformation of common warts into squamous cell carcinoma on sun-exposed areas in an immunosuppressed patient. […] The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). […] Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial.

• #13 Warts

  https://healthlibrary.rumcsi.org/Library/TestsProcedures/LabTests/85,P00326

  Warts are common skin growths caused by a type of virus called human papillomavirus (HPV). There are more than 100 types of HPV. Different types of warts are caused by different types of HPV. […] The symptoms of warts can look like other health conditions. See your healthcare provider for a diagnosis. […] Your healthcare provider will ask about your symptoms and health history. Your provider will give you a physical exam. The physical exam will include closely looking at your skin. Your provider may use a small blade to scrape away the top layers. There may be black dots beneath the top layers. These are tiny blood vessels that have clotted. […] Your healthcare provider may advise you to see a dermatologist, a provider who specializes in caring for the skin. The dermatologist may do a shave biopsy. A very small amount of the wart is shaved and sent to the lab to be examined.

• #14 Common Warts: Symptoms, Causes & Treatments | Ada Health

  https://ada.com/conditions/common-warts/

  In the majority of cases, a doctor or dermatologist will be able to diagnose common warts through a simple physical examination. If further confirmation is needed, a skin biopsy may be ordered. To do this, the top layer of a wart will be scraped off and sent to a laboratory for testing. This is a straightforward and minimally invasive procedure. […] Common warts will often disappear without treatment, especially in childhood. However, common warts can also be persistent and last for a significant amount of time. They can sometimes be painful and unsightly, especially when they form in clusters. In these cases, treatment options are available. […] Prescription wart treatments may be used in conjunction with home remedies or when home treatment options seem unlikely to clear the condition. The method chosen by the doctor or dermatologist will depend on the severity of the warts, the symptoms, and the general health of the person.

• #15 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. […] Koilocytic (vacuolated) cells are pathognomonic for warts.

• #16 Wart – UtahDERM Diagnoses

  https://utahderm.med.utah.edu/diagnoses/wart/

  Warts are benign skin proliferations caused by infection with human papillomavirus (HPV). […] The diagnosis of warts is usually a clinical diagnosis; however, biopsy can be done if in doubt. […] Diagnosis of warts is a clinical diagnosis, but biopsy can be performed if there is concern for malignancy. […] The diagnosis of warts is usually a clinical diagnosis; however, biopsy can be done if in doubt. Paring of overlying skin and dermoscopy can be helpful in making a diagnosis. If biopsy is performed, koilocytes are a characteristic finding.

• #17 Warts | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/warts

  Warts are typically diagnosed by their appearance, and treatment options range from cryotherapy and surgical removal to over-the-counter topical solutions. […] Diagnosis of warts is based on clinical appearance and biopsy is rarely needed. A primary sign of warts is the absence of skin lines crossing their surface and the presence of pinpoint black dots (thrombosed capillaries) or bleeding when warts are shaved. […] Differential diagnosis includes corns (clavi), lichen planus, seborrheic keratosis, skin tags, and squamous cell carcinomas. DNA (deoxyribonucleic acid) typing is available in some medical centers but is generally not needed.

• #18 Human Papillomavirus (HPV) Infection – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm

  Diagnosis of anogenital warts is usually made by visual inspection but can be confirmed by biopsy, which is indicated if lesions are atypical (e.g., pigmented, indurated, affixed to underlying tissue, bleeding, or ulcerated lesions). […] HPV testing is not recommended for anogenital wart diagnosis because test results are not confirmatory and do not guide genital wart management. […] Biopsy of an atypical wart might reveal HSIL or cancer of the anogenital tract. In this instance, referral to a specialist for treatment is recommended.

• #19 HPV Diagnosis & Detection | HPV DNA Tests Sometimes Used

  https://www.hpv.org.nz/hpv-diagnosis

  HPV is very common and most of us will have an HPV infection at some point in our lives. […] A person will know if they have HPV if they have visible genital warts or if they have a positive HPV test result as part of cervical screening. Those tests are still limited in terms of which HPV types they test for. […] Unfortunately, there is no test for HPV in either males or females that will test for all the types of HPV. This means that HPV testing is not part of a routine sexual health check up.

• #20 Warts: Types, Images, Treatment, and More

  https://www.healthline.com/health/skin/warts

  Common warts usually grow on the backs of your fingers and toes and on the knees. But they can appear elsewhere. […] Signs and symptoms of common warts can include: small bumps that can be hard, rough, and grainy; flesh-colored bumps with small black spots of clotted blood vessels; ability to spread to other areas through direct contact. […] You should see a doctor if: You have warts on your face or another sensitive part of your body (e.g., genitals, mouth, nostrils); You notice bleeding or signs of infection, such as pus or scabbing, around a wart; The wart is painful; The color of the wart changes; You have warts and diabetes or an immune deficiency, such as HIV or AIDS. […] If your wart doesn’t respond well to at-home treatments, your doctor may be able to help. […] Your doctor may freeze your wart with liquid nitrogen. This can be a bit painful but usually works well. More than one treatment may be required.

• #21 Warts

  https://www.pcds.org.uk/clinical-guidance/warts

  Warts are growths of the skin caused by infection with the Human Papillomavirus (HPV). More than 70 HPV subtypes are known. […] Common warts are mainly due to HPV 2. Present as firm papules with a rough surface. Most commonly found on the backs of the hands and fingers but can occur anywhere. […] Not all anogenital warts are sexually transmitted, however, in children a consideration has to be given to the possibility of sexual abuse. […] Management overview – for all: Set patient expectations. No treatment is a good first option – new warts often resolve spontaneously (30% within 10 weeks). […] Referral of warts (as per NICE) may be considered in exceptional circumstances including: an uncertain diagnosis, a persistent facial wart, extensive recalcitrant warts (ie not responding to treatment).

• #22 Pathology Outlines – Warts (verrucae)

  https://www.pathologyoutlines.com/topic/skinnontumorwarts.html

  Common warts: hyperkeratotic flesh colored papules with pinpoint black dots (thrombosed capillaries) (J Dtsch Dermatol Ges 2019;17:613) […] Diagnosis: Usually clinical diagnosis […] Biopsy can confirm clinical and rule out other entities (J Dtsch Dermatol Ges 2019;17:613)

• #23 Common Wart Condition, Treatments and Pictures for Adults – Skinsight

  https://skinsight.com/skin-conditions/common-wart-verruca-vulgaris/

  Warts are growths of the skin and mucous membranes (inside the mouth or genitals) that are caused by a virus known as the human papillomavirus (HPV). […] Common warts are rough, thick papules (solid bumps) ranging in size from 1 mm to over 10 mm, often on the hands, face, elbows, and knees. […] Because warts can resolve on their own, it is not necessary to treat all warts. Additionally, treating warts may not always destroy them, nor will it necessarily keep other warts from appearing. […] See a medical professional in the case of painful or bleeding warts. […] Warts on the face and those interfering with daily life that do not respond to self-care measures.

• #24 The Medical Minute: The worry with warts | Penn State University

  https://www.psu.edu/news/campus-life/story/medical-minute-worry-warts

  Common warts are harmless skin lesions that are usually found on the hands or soles of the feet, the latter referred to as plantar warts. […] Warts, especially plantar warts and those developing near fingernails are sometimes painful. […] Unless warts cause pain, there are no immediate reasons for treatment. […] HPV can be spread by direct contact with the warty skin of an infected person, although most contacts do not result in transmission. […] Self-inoculation may explain multiple warts on the same person and people with damaged skin or who are immunosuppressed are at increased risk for HPV infection. […] If the wart is not responding to over the counter therapies or you are not sure if it is a wart, consulting your primary care physician or dermatologist is recommended.

• #25 Warts in Children

  https://www.nationwidechildrens.org/conditions/health-library/warts-in-children

  How are skin warts diagnosed in a child? The health care provider will give your child a physical exam. A provider will usually diagnose warts based on their appearance. They may use a small blade to scrape away the top layers. There may be black dots beneath the top layers. These are tiny blood vessels that have clotted. Your child’s provider may recommend that your child see a skin specialist (dermatologist). The dermatologist may do a shave biopsy to verify the diagnosis. A very small amount of the wart is shaved and sent to the lab to be examined. […] Warts on the skin are small, noncancerous skin growths. They are caused by one of the human papillomaviruses. […] Warts are more common in children than adults, although they can develop at any age. […] There are many different types of warts with different appearances. […] Most warts go away without treatment, but it may take weeks or months. […] Warts can be treated with over-the-counter medicines. Other treatments may be prescribed by your child’s health care provider.

• #26 HPV Symptoms: Warts, Genital Warts, Cancer

  https://www.everydayhealth.com/hpv/guide/symptoms/

  Skin warts and genital warts can usually be diagnosed on sight during a physical examination, but your doctor may also refer you to a dermatologist for a biopsy (removal of tissue for examination under a microscope) to be sure your skin condition is a wart. […] For women, a doctor may perform a colposcopy a procedure that uses a light and a low-power microscope to find genital warts on your cervix that are too small to see with the naked eye, or to look for precancerous changes in the tissue of the cervix, vagina, or vulva. […] The HPV test can detect HPV types 16 and 18 considered the highest-risk HPV types for cancer and provide broad results for 12 other high-risk HPV types in tissue of the cervix. […] The Pap test can detect precancerous changes in tissue of the cervix, and may be used for screening when a primary HPV test (an HPV test approved for stand-alone use) isn’t available. […] A positive HPV test will generally be followed up with a colposcopy if HPV type 16 or 18 is found. […] Cancers or precancerous changes in areas other than the cervix are typically diagnosed by taking a biopsy of abnormal-appearing areas and examining the tissue under a microscope.

• #27 Viral Warts: Causes and Treatment | Doctor

  https://patient.info/doctor/viral-warts-excluding-verrucae

  Warts are classified according to their appearance or site. […] Diagnosis is usually obvious clinically but, if necessary, paring down will produce pinpoint bleeding of the capillaries in the roots of the wart. […] Reasons to consider referral to secondary care include uncertain diagnosis, persistent symptomatic warts unresponsive to primary care treatment, multiple warts in immunocompromised individuals, facial warts, and extensive coverage (eg, mosaic warts).

• #28 Warts’ causes, symptoms and treatments here – TeleMed2U

  https://www.telemed2u.com/dermatology/warts

  Your doctor or dermatologist can diagnose a common wart by physical examination. He or she may scrape off the top layer or remove a small section (biopsy) for lab analysis to rule out skin cancer or other skin conditions. […] The goals of treatment are to destroy the wart and get an immune system response to fight the virus. Treatment can take weeks or months. Warts often go away without treatment, especially in children. Warts in adults may take longer to disappear. […] Although warts are harmless, any growth that bothers you, has changed, or you cant get rid of should be evaluated by a dermatologist. Before warts are treated they can shed the HPV virus cells into the skin, allowing new warts to grow around the original warts. To avoid this, have your dermatologist treat new warts immediately. Even with treatment, warts tend to return or spread.

• #29 Common warts – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/615/common-warts

  Common warts, also known as verrucae vulgaris, are caused by human papillomavirus infection and affect most people during their lifetimes. They are most common in children and young adults. […] Common warts should be distinguished from serious conditions that mimic them, such as squamous cell carcinoma, especially in immunocompromised patients. […] The goals of treatment are to destroy the lesion, induce cytotoxicity against infected cells, and promote antiviral immune responsiveness to prevent recurrence. […] Best outcomes are achieved with a combination of destructive and immune sensitization approaches. […] Most common warts in healthy people resolve spontaneously. Clearance rates in children from time of diagnosis to clearance are 23% at 2 months, 30% at 3 months, 65% to 78% at 2 years, and 90% at 5 years.

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