Brodawki zwykłe – Epidemiologia

Brodawki zwykłe
Epidemiologia

Brodawki zwykłe (verruca vulgaris), wywoływane przez HPV (głównie typy 1, 2, 4, 7, 27, 57), stanowią około 70% brodawek skórnych o etiologii niegenitalnej i występują u 7-12% populacji, z najwyższą częstością wśród dzieci w wieku 12-16 lat (10-33%). U dorosłych częstość spada do 3-5%. Ryzyko zakażenia wzrasta u osób z obniżoną odpornością komórkową (np. pacjenci z AIDS, po przeszczepach), atopowym zapaleniem skóry, sportowców oraz pracowników mających kontakt z mięsem i rybami. Transmisja wirusa następuje głównie przez bezpośredni kontakt skóry, z okresem inkubacji 2-6 miesięcy. Brodawki wykazują tendencję do samoistnego ustępowania – u dzieci 23% po 2 miesiącach, 65-78% po 2 latach, a 90% po 5 latach; u dorosłych proces ten jest dłuższy, a u osób immunosupresyjnych brodawki mogą być bardziej oporne na leczenie.

Epidemiologia brodawek zwykłych

Brodawki zwykłe (verruca vulgaris) są jednymi z najczęstszych zmian skórnych wywoływanych przez wirusa brodawczaka ludzkiego (HPV). Stanowią około 70% wszystkich brodawek skórnych o etiologii nie-genitalnej.¹² Szacuje się, że brodawki skórne występują u około 7-12% populacji ogólnej, jednak częstość ich występowania różni się w zależności od wieku, płci, regionu geograficznego oraz stanu immunologicznego pacjentów.³⁴

Występowanie brodawek zwykłych w różnych grupach wiekowych

Brodawki zwykłe mogą występować w każdym wieku, jednak wykazują charakterystyczny rozkład częstości w zależności od wieku:⁵⁴

Są rzadkie u niemowląt i w okresie wczesnego dzieciństwa
Częstość występowania zwiększa się wśród dzieci w wieku szkolnym
Najwyższa częstość występowania przypada na okres między 12 a 16 rokiem życia
U osób dorosłych częstość występowania znacząco spada

⁶

Wśród dzieci w wieku szkolnym, rozpowszechnienie brodawek zwykłych jest szczególnie wysokie i sięga od 10% do 20%, a niektóre badania sugerują, że nawet do 33% dzieci i nastolatków ma brodawki.⁷⁸ Natomiast u dorosłych szacunkowe rozpowszechnienie jest znacznie niższe i wynosi około 3-5%.⁷

Badania przeprowadzone w holenderskich szkołach wykazały, że brodawki skórne występują u około jednej trzeciej uczestników, a częstość wzrasta z wiekiem – od około 15% w wieku 4 lat do około 44% w wieku 11 lat, bez różnic między płciami.⁹

Różnice płciowe i etniczne w występowaniu brodawek zwykłych

Stosunek zachorowań między mężczyznami a kobietami jest zbliżony do 1:1, chociaż niektóre badania wskazują na drobne różnice między płciami.¹⁰⁴ W badaniu przeprowadzonym wśród chińskich studentów stwierdzono znacząco wyższą częstość występowania brodawek wśród mężczyzn (2,0%) w porównaniu do kobiet (0,9%).¹¹

W kontekście różnic etnicznych, brodawki zwykłe występują około dwukrotnie częściej u osób rasy białej niż u osób rasy czarnej czy Azjatów.⁵⁴ Natomiast ogniskowy przerost nabłonka (choroba Hecka) występuje częściej wśród rdzennych Amerykanów i Inuitów.⁶

Grupy ryzyka i czynniki predysponujące

Zwiększone ryzyko występowania brodawek zwykłych obserwuje się w następujących grupach:¹²¹³

Osoby z obniżoną odpornością komórkową (np. pacjenci z AIDS, po przeszczepach narządów) – częstość występowania może być 50-100 razy wyższa niż w populacji ogólnej, dotykając ponad 90% takich pacjentów³
Osoby z atopowym zapaleniem skóry¹⁴
Pracownicy wykonujący określone zawody – szczególnie osoby mające kontakt z mięsem, drobiem i rybami⁵
Sportowcy, zwłaszcza uprawiający sporty, które wiążą się z zwiększonym ryzykiem mikrourazów skóry¹⁵

Do głównych czynników ryzyka zakażenia HPV i rozwoju brodawek zwykłych należą:¹⁶

Bezpośredni kontakt z osobą, która ma brodawki
Posiadanie już istniejących brodawek (ryzyko autoinokulacji)
Mikrourazy skóry, które umożliwiają wniknięcie wirusa
Chodzenie boso w miejscach publicznych (baseny, szatnie, prysznice)
Obniżona odporność

Transmisja i czynniki sprzyjające zakażeniu

Wirus HPV odpowiedzialny za brodawki zwykłe przenosi się głównie poprzez bezpośredni kontakt skóry ze skórą lub kontakt z powierzchniami skażonymi wirusem.¹² Człowiek jest jedynym naturalnym rezerwuarem wirusa HPV.¹⁷

Okres inkubacji wirusa wynosi zazwyczaj od dwóch do sześciu miesięcy, choć może trwać nawet dłużej.¹²¹³ HPV jest bardziej skłonny do infekowania skóry uszkodzonej lub zmiękczonej przez wodę, ale może również zainfekować zdrową skórę.¹³

Badania dotyczące transmisji wirusa wykazały, że dwa najważniejsze czynniki ryzyka to:¹⁶

Posiadanie już istniejącej brodawki
Bliski kontakt z osobą, która ma brodawkę

Brodawki zwykłe zawierają bardzo wysoką liczbę cząstek wirusowych, co zwiększa tempo uwalniania wirusa i prawdopodobieństwo skażenia sąsiednich powierzchni ciała, przedmiotów używanych wspólnie lub osób z bliskiego otoczenia.¹⁶ Badanie przeprowadzone wśród holenderskich uczniów wykazało, że główne czynniki ryzyka obejmowały bliskich członków rodziny z brodawkami oraz rodziny z wieloma dziećmi. Co ciekawe, transmisja poprzez publiczne toalety i przebieralnie nie była statystycznie istotna w tym badaniu.¹⁸

Naturalny przebieg i samoistne ustępowanie

Ważnym aspektem epidemiologii brodawek zwykłych jest ich tendencja do samoistnego ustępowania, szczególnie u osób z prawidłowo funkcjonującym układem odpornościowym:¹⁹

U dzieci wskaźniki ustępowania brodawek od momentu diagnozy wynoszą: 23% po 2 miesiącach, 30% po 3 miesiącach, 65-78% po 2 latach i 90% po 5 latach²⁰
U osób dorosłych samoistne ustępowanie zwykle trwa dłużej i może zająć kilka lat²¹
U osób z niedoborami odporności brodawki mogą utrzymywać się dłużej i być bardziej oporne na leczenie¹⁶

W badaniu długoterminowym wykazano, że nieco ponad połowa pacjentów doświadcza samoistnego ustąpienia brodawek w ciągu dwóch lat od początkowego badania. Wiek pacjenta, jakość snu i poziom wykształcenia ojca okazały się czynnikami niezależnie związanymi z ustępowaniem brodawek.¹¹

Globalne rozpowszechnienie i dane z różnych regionów

Rozpowszechnienie brodawek zwykłych różni się w zależności od regionu geograficznego. Według kompleksowych analiz epidemiologicznych z 2021 roku, całkowita liczba zdiagnozowanych przypadków brodawek zwykłych w 7 głównych rynkach (7MM: USA, Niemcy, Francja, Włochy, Hiszpania, Wielka Brytania i Japonia) plus Chinach wynosiła około 21 826 945, z następującym rozkładem:²²²³

Stany Zjednoczone: około 2 805 077 przypadków (13% całkowitej liczby)
UE-5 (Niemcy, Francja, Włochy, Hiszpania, Wielka Brytania): około 10 761 864 przypadków
Chiny: około 6 894 784 przypadków (32% całkowitej liczby) – najwyższa liczba przypadków
Japonia: około 1 365 220 przypadków – najniższa liczba przypadków wśród analizowanych krajów

Różnice w częstości występowania brodawek w różnych krajach mogą być znaczące. Na przykład szacuje się, że tylko 0,84% populacji Stanów Zjednoczonych ma brodawki podeszwowe, podczas gdy w Rosji odsetek ten wynosi 12,9%.¹⁶

Nowsze dane z 2023 roku wskazują, że liczba zdiagnozowanych przypadków brodawek zwykłych w 7MM wynosiła około 14 milionów i oczekuje się, że znacząco wzrośnie do 2034 roku z powodu zwiększonej świadomości choroby i poprawy diagnostyki.²⁴

Związek z typem wirusa HPV

Brodawki zwykłe są najczęściej wywoływane przez HPV typy 1, 2, 4, 7, 27 i 57, przy czym różne typy wirusa mogą wpływać na epidemiologię i morfologię brodawek:¹⁹²⁵

Zakażenia HPV typu 1 najczęściej występują u dzieci w wieku 6-10 lat
Zakażenia HPV typów 2, 27 i 57 przeważają u osób w wieku 10-30 lat i zazwyczaj wiążą się z dłuższym przebiegiem choroby (średni czas trwania brodawek w momencie pierwszego badania klinicznego wynosił 22 miesiące)
Brodawki wywołane przez HPV typu 2 wykazują umiarkowaną odpowiedź na leczenie – utrzymują się u około 50% pacjentów przez ponad 6 dodatkowych miesięcy

Te różnice sugerują, że epidemiologia i morfologia brodawek zwykłych są ściśle powiązane z typem wirusa.²⁵

Nadzór i monitorowanie epidemiologiczne

Zakażenia HPV i brodawki zwykłe nie są objęte obowiązkiem zgłaszania w większości systemów nadzoru chorób zakaźnych.²⁶²⁷ Jednak specjalne badania monitorujące zakażenia HPV i choroby związane z HPV mogą pomóc określić wpływ szczepionek przeciwko HPV.²⁷

W Stanach Zjednoczonych dane dotyczące nowotworów związanych z HPV są zbierane w dwóch rejestrach nowotworów – NPCR (National Program of Cancer Registries) i SEER (Surveillance, Epidemiology, and End Results), które łącznie zbierają dane o nowotworach diagnozowanych u 100% populacji USA.²⁸

Badania epidemiologiczne brodawek zwykłych często wykorzystują następujące metody:²⁹

Badania przekrojowe w populacjach szkolnych
Analizy danych z poradni dermatologicznych
Badania kohortowe pacjentów z brodawkami
Badania post-marketingowe nowych metod leczenia

Przykładem takiego monitoringu jest badanie post-marketingowe urządzenia mikrofalowego (Swift, Emblation Limited) stosowanego w leczeniu brodawek skórnych. W badaniu uczestniczyło 126 klinik, a leczeniu mikrofalowemu poddano 6998 dorosłych (81,9% z brodawkami podeszwowymi; 18,1% z brodawkami zwykłymi, nie-podeszwowymi).³⁰³¹

Wpływ szczepień przeciwko HPV

Szczepionki przeciwko HPV mogą wpływać na epidemiologię brodawek zwykłych, chociaż ich głównym celem jest zapobieganie nowotworom związanym z HPV, szczególnie rakowi szyjki macicy.²⁸¹⁹

W ostatnich latach zaobserwowano znaczący spadek występowania brodawek narządów płciowych w krajach, w których wprowadzono programy szczepień przeciwko HPV.³² Chociaż brodawki zwykłe i brodawki narządów płciowych są wywoływane przez różne typy HPV, te obserwacje sugerują, że kompleksowe programy szczepień mogą mieć szerszy wpływ na epidemiologię zakażeń HPV.³³

Przegląd systematyczny wykazał, że 5-8 lat po wprowadzeniu szczepień w krajach o wysokich dochodach, liczba diagnoz brodawek narządów płciowych zmniejszyła się o 67% wśród dziewcząt w wieku 15-19 lat, o 54% wśród kobiet w wieku 20-24 lat i o 31% wśród kobiet w wieku 25-29 lat. Równolegle, liczba diagnoz zmniejszyła się o 48% wśród chłopców w wieku 15-19 lat i o 32% wśród mężczyzn w wieku 20-24 lat.³³

Znaczenie epidemiologiczne i obciążenie systemów opieki zdrowotnej

Chociaż brodawki zwykłe rzadko stanowią poważne zagrożenie dla zdrowia, ich wysoka częstość występowania powoduje znaczące obciążenie dla systemów opieki zdrowotnej:³⁴

Brodawki stanowią trzecią najczęstszą przyczynę wizyt w pediatrycznych poradniach dermatologicznych, stanowiąc około 16% takich wizyt¹
2% dorosłych i 6% dzieci rocznie korzysta z opieki medycznej z powodu brodawek podeszwowych³⁵
Brodawki zwykłe stanowią około 70% wszystkich brodawek wirusowych³⁴

Oprócz kosztów bezpośrednich związanych z leczeniem, brodawki mogą powodować dyskomfort fizyczny, zaburzenia funkcjonalne i problemy psychospołeczne, szczególnie gdy są liczne, duże lub zlokalizowane w widocznych miejscach.²¹

Trendy i prognozy epidemiologiczne

Oczekuje się, że całkowita liczba zdiagnozowanych przypadków brodawek zwykłych w 7MM i Chinach będzie wzrastać w tempie 0,2% rocznie (CAGR) w okresie prognozy.²² Ten wzrost może być częściowo przypisany zwiększonej świadomości choroby i poprawie diagnostyki.²⁴

Jednocześnie, w niektórych regionach, jak Japonia, przewiduje się spadek liczby przypadków w tempie -0,4% rocznie w okresie prognozy (2022-2032).³⁶

Rynek leczenia brodawek zwykłych ma wzrosnąć przy znaczącym CAGR wynoszącym 14,41% w 7MM w okresie badania (2019-32), głównie z powodu wzrostu częstości występowania brodawek zwykłych oraz wprowadzenia nowych metod leczenia.³⁴

Podsumowując, brodawki zwykłe stanowią powszechny problem zdrowotny, szczególnie wśród dzieci i młodych dorosłych. Ich epidemiologia jest złożona i zależna od wielu czynników, w tym wieku, płci, stanu immunologicznego, typu wirusa HPV oraz regionu geograficznego. Mimo że większość brodawek zwykłych ustępuje samoistnie, szczególnie u osób z prawidłowo funkcjonującym układem odpornościowym, stanowią one znaczące obciążenie dla systemów opieki zdrowotnej i mogą mieć istotny wpływ na jakość życia pacjentów.

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Materiały źródłowe

#1 Common Warts | Obgyn Key
https://obgynkey.com/common-warts/
Nongenital cutaneous warts are widespread worldwide and are more common in children, with a peak incidence in the teenage years and a sharp decline thereafter. Warts are the third most common reason for a pediatric general dermatology clinic visit accounting for about 16 percent of such visits. […] They are most commonly caused by HPV types 15, 7, 27, and 29. […] Common warts account for approximately 70 percent of nongenital cutaneous warts. […] Common warts occur most commonly in children and young adults.
#2 Common Warts | Basicmedical Key
https://basicmedicalkey.com/common-warts/
Nongenital cutaneous warts are widespread worldwide and are more common in children, with a peak incidence in the teenage years and a sharp decline thereafter.1 […] Common warts account for approximately 70% of nongenital cutaneous warts.2 […] Common warts occur most commonly in children and young adults (Figures 131-1and131-2).3
#3 Azthena logo with the word Azthena
https://www.news-medical.net/health/What-are-Warts.aspx
HPV infection and the subsequent development of warts that are very commonly observed represent the most common viral infection of the skin, affecting 7% to 10% of the general population. […] These numbers can be 50 to 100 times higher in immunocompromised individuals, such as kidney-transplant recipients or those on chemotherapy, where it affects more than 90% of patients. […] Warts may occur throughout an individual’s lifetime; however, there is an increased incidence during school age, reaching a peak in adolescence and early adulthood. […] Cross-sectional studies conducted in schools have shown that the prevalence of warts in children varies between 2% and 20%. […] If the workplace is considered a risk factor, handlers of meat, poultry, and fish have a higher prevalence in comparison to other workers.
#4 Nongenital Warts: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1133317-overview
Warts are widespread in the worldwide population. Although the frequency is unknown, warts are estimated to affect approximately 7-12% of the population. In school-aged children, the prevalence is 10-20%. An increased frequency also is seen among immunosuppressed patients and meat handlers. […] Although warts may affect any race, common warts appear approximately twice as frequently in whites as in blacks or Asians. Focal epithelial hyperplasia (Heck disease) is more prevalent among American Indians and Inuit. […] Male-to-female ratio approaches 1:1. […] Warts can occur at any age. They are unusual in infancy and early childhood, increase in incidence among school-aged children, and peak at 12-16 years.
#5 Wart | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/31113
Warts are a common medical problem, especially in Whites. […] Warts are common worldwide and affect approximately 10% of the population. In school-aged children, the prevalence is as high as 10% to 20%. They are more common among immunosuppressed patients and meat handlers. […] Warts can occur at any age. Although rare in infancy and early childhood, prevalence increases among school-aged children and peaks at 12 to 16 years. […] Warts are twice as common in Whites as in Blacks or Asians. Focal epithelial hyperplasia (Heck disease) is more prevalent in Inuit and American Indians. […] The male-to-female ratio is approximately equal.
#6 Wart – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK431047/
Warts are a common medical problem, especially in Whites. […] Warts are common worldwide and affect approximately 10% of the population. In school-aged children, the prevalence is as high as 10% to 20%. They are more common among immunosuppressed patients and meat handlers. […] Warts can occur at any age. Although rare in infancy and early childhood, prevalence increases among school-aged children and peaks at 12 to 16 years. […] Warts are twice as common in Whites as in Blacks or Asians. Focal epithelial hyperplasia (Heck disease) is more prevalent in Inuit and American Indians.
#7 Overview: Warts – InformedHealth.org – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK279586/
Warts are contagious and very common: Most people will have one at some point in their lives. […] Warts are very common, especially among children and teenagers. Various studies have shown that up to 33% of children and teenagers have warts. The estimated prevalence in adults is much lower, at about 3 to 5%.
#8 Viral Warts: Causes and Treatment | Doctor
https://patient.info/doctor/viral-warts-excluding-verrucae
Warts are very common and thought to affect 7-12% of the population.1 No large studies are available; however, small studies suggest up to 30% of children and young adults may have warts.2 […] Incidence is thought to be higher in children of school age than in preschool children and to peak in teenage years.3
#9 SciELO Brazil – Update on human papilloma virus – part I: epidemiology, pathogenesis, and clinical spectrum^,^, Update on human papilloma virus – part I: epidemiology, pathogenesis, and clinical spectrumhttps://www.scielo.br/j/abd/a/ZZtwyNTQsx3RfBfhpctD8rt/
Currently, approximately 218 types of HPV have been isolated and identified as causing infections in humans. Of these, 45 infect the genital tract, while the others will cause skin disease. Alpha HPVs produce clinically visible lesions on mucous membranes and skin, while beta and gamma HPVs are mainly responsible for persistent subclinical skin lesions secondary to infections acquired early in childhood. The infection occurs predominantly via direct contact, although skin lesions can be transmitted indirectly, via contaminated surfaces. Microtraumas expose the basal layer keratinocytes and facilitate contagion. […] […] Cutaneous warts (CWs) related to non-sexually transmitted HPV types have completely different epidemiological characteristics and are mainly caused by types 1, 2, 4, 27, and 57. Although these are the most prevalent types in several studies, the proportion of individuals affected by each of them is quite variable. Some authors speculate that the differences are due to socio-geographical variations. A study conducted in Dutch schools found CWs in approximately one-third of the participants, with the prevalence increasing with age, from about 15% at 4 years to about 44% at 11 years, with no difference between genders. Infection with HPV 1 affects a younger age group, more often on the plantar region, with fewer and smaller lesions, while HPV 2 is responsible for the second peak, in the second and third decades of life. […]
#10 HPV 1, 2, & 4
https://web.stanford.edu/group/virus/papilloma/2004goglincarnevale/Papilloma/HPV1.htm
HPV 1, 2, and 4 cause benign nongenital skin warts such as plantar and common warts. Although the frequency is unknown, warts are estimated to affect approximately 7 to 12% of the population. They occur most frequently in older children and young adults. Some school surveys estimate a prevalence of about 10% in older school children, with a peak at around 12 to 16 years. There is a low incidence of warts in older people, indicating that their immune systems may render them more resistant to infection. Although warts may affect any race, common warts appear approximately twice as frequently in whites as in blacks or Asians. The frequency of warts is about the same in men and women.
#11 Epidemiology and Clinical Profile of Cutaneous Warts in Chinese College Students: A Cross-Sectional and Follow-Up Study | Scientific Reports
https://www.nature.com/articles/s41598-018-33511-x
Of the 15,384 students, 215 were diagnosed with cutaneous warts, with an overall prevalence of 1.4% (95% CI, 1.21.6%). The prevalence was significantly higher in male than in female students (2.0% vs. 0.9%, P0.0001) and in students from rural than those from urban areas (1.7% vs. 1.3%, P=0.03). The prevalence tended to be negatively associated with maternal and paternal education levels (p for trend test=0.070 and 0.014, respectively). […] In this study, we found that 1.4% of college students were affected with warts on their hands and/or feet. The majority of patients had only one wart on the hand or foot and the majority of warts were 1cm in diameter. Slightly over half of patients experienced spontaneous resolution of warts within two years after the initial survey. Patients age, sleep quality, and paternal education level were shown to be independently associated with the resolution of warts.
#12 Cutaneous warts (common, plantar, and flat warts) – UpToDate
https://www.uptodate.com/contents/cutaneous-warts-common-plantar-and-flat-warts
Cutaneous warts occur most commonly in children and young adults and are more common among certain occupations, such as handlers of meat, poultry, and fish. […] Predisposing conditions for extensive or recalcitrant involvement include atopic dermatitis and conditions associated with decreased cell-mediated immunity (eg, acquired immunodeficiency syndrome [AIDS], organ transplantation). […] Infection with human papillomavirus (HPV) occurs by direct skin contact, with maceration or sites of trauma predisposing patients to inoculation. […] The reservoir for HPV appears to be individuals with clinical or subclinical infection. […] The incubation period is approximately two to six months. […] Spontaneous remission of warts occurs in two-thirds of children within two years; spontaneous resolution in adults tends to be slower and may take up to several years or longer. […] Warts in patients with intact cellular immunity are the most likely to regress without therapy. […] Recurrence is common.
#13 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 are growths on the skin that are caused by a virus called human papillomavirus (HPV). HPV infection is common; there are different types, some of which can cause warts. […] Common, plantar, and flat warts are most common in children and young adults. People with certain jobs, such as handling meat, fish, and poultry, may also be more likely to develop common warts. People who have chronic skin conditions, such as eczema, and people with a weakened immune system (eg, from AIDS or after an organ transplant) may have more extensive warts or warts that are difficult to control. […] People can become infected with the virus that causes warts (HPV) by touching another person’s wart. HPV is more likely to infect skin that is injured or softened by water, but they can infect healthy skin as well. It can take up to six months or longer after exposure to the virus for a wart to appear.
#14
https://step1.medbullets.com/dermatology/112092/cutaneous-warts-verrucae
common warts (verruca vulgaris) […] Epidemiology […] demographics […] children and young adults […] risk factors […] atopic dermatitis […] immunosuppression […] walking barefoot in communal swimming areas […] occupations […] handlers of meat and fish
#15 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOorhCW-OnxcJyDsU-TGbDfAlAiMVZCx-bLBPurZ2TDZyar0rKfJt
Athletes have been observed to have higher rates of warts, including plantar warts, compared with the general population. […] Immunocompromised patients have higher rates of plantar warts, along with increased severity and duration of the lesions. […] Plantar wart incidence varies with age, sex, race, and health status.
#16 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en
It is estimated that only 0.84% of the United States population have plantar warts, whereas 12.9% of the Russian population has been shown to have plantar warts. […] Two percent of the adult population and 6% of the pediatric population seek care for a plantar wart annually. […] Plantar warts occur most frequently in children and adolescents, although they are rare in patients younger than 5 years. […] In terms of the sex distribution of plantar warts, incidence rates have been noted to change depending on patient age. […] Two of the most significant risk factors for developing plantar warts are (1) having a preexistent wart and (2) having close contact with someone who has a preexistent wart. […] 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. […] Athletes have been observed to have higher rates of warts, including plantar warts, compared with the general population. […] Immunocompromised patients have higher rates of plantar warts, along with increased severity and duration of the lesions.
#17 Chapter 11: Human Papillomavirus | Pink Book | CDC
https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-11-human-papillomavirus.html
HPV infection is extremely common throughout the world. Most sexually active adults will have an HPV infection at some point during their lives, although they may be unaware of their infection. […] Humans are the only natural reservoir for HPV. Other viruses in the papillomavirus family affect other species. […] HPV is transmitted through intimate, skin-to-skin contact with an infected person. Transmission is most common during vaginal, penile, anal, or oral sex. […] HPV is presumed to be communicable during both acute and persistent infections. Communicability can be presumed high because of the large number of new infections estimated to occur each year. […] Risk factors for HPV infection are primarily related to sexual behavior, including higher numbers of lifetime and recent sex partners. Results of epidemiologic studies are less consistent for other risk factors, including younger age at sexual initiation, higher number of pregnancies, genetic factors, smoking, and lack of circumcision of the male partner.
#18 SciELO Brazil – Update on human papilloma virus – part I: epidemiology, pathogenesis, and clinical spectrum^,^, Update on human papilloma virus – part I: epidemiology, pathogenesis, and clinical spectrumhttps://www.scielo.br/j/abd/a/ZZtwyNTQsx3RfBfhpctD8rt/
The main risk factors found in school patients were close family members with CWs and families with multiple children. Transmission via public toilets and changing rooms was not statistically relevant in that study. Autoinoculation is also described, especially in the presence of lesions in the fingers. The prevalence of CWs in the general population is estimated at around 5% and is the result of continuous and repeated infection by multiple types. […] […] Genital HPV lesion is the most prevalent STI in the world. In Brazil, a recent systematic review carried out by Colpani et al. observed the following prevalences of HPV in mucosal lesions: 36.21% in the penile region; 25.68% in the anal region; 24.11% in the uterine cervical region; and 11.89% in the oral region. The study included more than 50,000 participants of all ages; the prevalence was higher than that of Central America (13%) and Western Europe (9%). Another multicenter, community-based Brazilian study of unvaccinated young people found high-risk HPV (HR-HPVs) in 35.2% of individuals, with a predominance of women. However, when analyzing sexually active young people, this percentage reached 53.5% for all types of HPV, regardless of sex. It is estimated that 75% of sexually active adults will have at least one HPV infection in their lifetime. The most frequently involved are types 6 and 11, present in about 80% of oral lesions and more than 90% of genital lesions. Risk factors include number of partners and age at first sexual intercourse, immunosuppression (including HIV), and the presence of other STIs, such as herpes simplex. The relationship with smoking and the use of oral contraceptives remains controversial. Contagion can occur through any form of sexual contact, even without penetration. The incidence of anal infection is high among men who have sex with men (MSM). Lesions in men appear to be less persistent than in women. […]
#19 Warts – Dermatologic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts
Warts are almost universal in the population; they affect patients of all ages but are most common among children and are uncommon among older adults. […] Common warts (verrucae vulgaris) are caused by HPV types 1, 2, 4, and 7 and occasionally other types in immunosuppressed patients. […] In immunocompetent patients, common warts usually spontaneously regress within 2 to 4 years, but some linger for many years. […] 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. […] HPV vaccines protect against some of the types of HPV that cause warts and cancer.
#20 Common warts – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/615
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. […] 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.
#21 Destructive therapies for cutaneous warts: A review of the evidence
https://www1.racgp.org.au/ajgp/2022/october/destructive-therapies-for-cutaneous-warts
Common warts (Verruca vulgaris), plantar warts (Verruca plantaris) and flat/plane warts (Verruca plana), collectively known as cutaneous warts, are benign growths of the skin caused by the human papillomavirus (HPV). In Australia, up to 24% of children and 5% of adults are affected. […] A break in the epidermal barrier of the skin allows entry of HPV and subsequent infection of basal epithelial cells. HPV replicates alongside the natural lifecycle of epithelial cells, and is eventually released from desquamated keratinocytes on the surface of warts, potentially infecting other sites via direct contact or through fomites. […] Cutaneous warts generally self-resolve. Up to two-thirds of immunocompetent children experience spontaneous clearance of their cutaneous warts by two years of age. Adults tend to take longer. Patients might request treatment for their warts when they cause discomfort, functional impairment, social ostracism, are numerous, grow large or raise concerns regarding transmission. […] To attenuate transmission, hygienic practices need to be adopted in conjunction with any treatment. Important considerations when treating patients with warts include the location of the wart, the evidence supporting the proposed treatment and potential adverse effects of treatment.
#22 Common Warts – Epidemiology Forecast – 2032
https://www.researchandmarkets.com/reports/5633021/common-warts-epidemiology-forecast-2032?srsltid=AfmBOoojjhHZ2-Rx_7D4WTO3xMc4VwPuiOposj-Ft_tuh2H0cKzvcRGc
This Common Warts- Epidemiology Forecast-2032′ report delivers an in-depth understanding of the Common Warts, historical and forecasted epidemiology as well as the Common Warts epidemiology trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), Japan and China. […] The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by total diagnosed prevalent cases of Common Warts, and gender-specific diagnosed prevalent cases of Common Warts in the 7MM plus China covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), Japan, and China from 2019 to 2032. […] As per the assessment of the publisher, the total diagnosed prevalent cases of Common Warts in the 7MM + China was found to be approximately 21,826,945 in 2021, which is expected to increase at a Compound Annual Growth Rate (CAGR) of 0.2% during the study period.
#23 Common Warts Epidemiology Forecast Report 2022- 2032 – ResearchAndMarkets.com
https://www.businesswire.com/news/home/20220727005888/en/Common-Warts-Epidemiology-Forecast-Report-2022–2032—ResearchAndMarkets.com
Common Warts – Epidemiology Forecast – 2032 report delivers an in-depth understanding of the Common Warts, historical and forecasted epidemiology as well as the Common Warts epidemiology trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), Japan and China. […] The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by total diagnosed prevalent cases of Common Warts, and gender-specific diagnosed prevalent cases of Common Warts in the 7MM plus China covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), Japan, and China from 2019 to 2032. […] As per the assessment of the publisher, the total diagnosed prevalent cases of Common Warts in the 7MM + China was found to be approximately 21,826,945 in 2021, which is expected to increase at a Compound Annual Growth Rate (CAGR) of 0.2% during the study period.
#24 Common Warts Market Report 2034: Epidemiology Data, Pipeline Therapies, Latest FDA, EMA, PDMA Approvals by DelveInsight
https://www.einpresswire.com/article/726474855/common-warts-market-report-2034-epidemiology-data-pipeline-therapies-latest-fda-ema-pdma-approvals-by-delveinsight
The prevalence of common warts appears to be on the rise, due to increased awareness and diagnosis of these skin lesions, prompting more individuals to seek medical attention. […] There were around 14 million diagnosed prevalent cases of common warts in the 7MM, in 2023. These cases are expected to rise significantly by 2034, due to an increase in disease awareness and improved diagnosis. […] The US had the highest diagnosed prevalent cases of common warts among the 7MM, accounting for nearly 20% of the total cases in 2023. […] Among EU4 and the UK, Germany accounted for the highest percentage of cases, with nearly 25% of the total cases in EU4 and the UK, followed by France, the UK, Italy, and Spain. […] As per DelveInsight analysis, Japan accounted for the least diagnosed prevalent cases of common warts, among the 7MM countries, with nearly 1.3 million cases in 2023.
#25
https://link.springer.com/article/10.1007/s004030050201
Warts induced by the related HPV types 2, 27 and 57 predominated in the study population (n = 202). […] Patients aged between 10 and 30 years were most affected and they typically displayed a long disease history (mean duration of warts at the time of first clinical examination, 22 months). […] A different age distribution was observed in HPV 1-induced warts, most of which occurred in children 6-10 years of age. […] HPV 2-related warts responded only modestly to treatment, as they persisted in approximately 50% of all patients for more than 6 additional months. […] Thus, our results indicate that the epidemiology, as well as morphology, of common warts is closely linked to the virus type.
#26 Chapter 11: Human Papillomavirus | Pink Book | CDC
https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-11-human-papillomavirus.html
Genital HPV infection is the most common sexually transmitted infection in the United States and worldwide. […] The National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) program and CDC’s National Program of Cancer Registries provide data on the number of HPV cancers in the United States. On average, 43,999 HPV-associated cancers are reported annually, including 24,886 in females and 19,113 in males. […] HPV infection is not a nationally notifiable condition. For information on guidance for state and local health department staff who are involved in surveillance activities for vaccine-preventable diseases, please consult the Manual for the Surveillance of Vaccine-Preventable Diseases.
#27 Chapter 5: Human Papillomavirus | Manual for the Surveillance of Vaccine-Preventable Diseases | CDC
https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-5-human-papillomavirus.html
This chapter provides general guidance for vaccine-preventable disease surveillance, describing the disease background/epidemiology, case investigation and reporting/notification, disease case definitions, and activities for enhancing surveillance, case investigation, and outbreak control for human papillomavirus. […] Genital human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. An estimated 14 million persons newly infected every year, resulting in approximately $1.7 billion (estimates range from $800 million to $2.9 billion) in direct medical costs. […] HPV was detected in about 90% of cervical cancers. […] HPV infections are not nationally notifiable. […] However, special studies to monitor HPV infection and HPV-associated diseases can help determine the impact of HPV vaccines. Existing and new systems are in place to monitor coverage and impact of HPV vaccine on short-, medium-, and long-term HPV-related outcomes in the United States.
#28 Chapter 5: Human Papillomavirus | Manual for the Surveillance of Vaccine-Preventable Diseases | CDC
https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-5-human-papillomavirus.html
The primary goal of HPV vaccination is to prevent cervical cancers, other HPV-associated cancers, and genital warts associated with vaccine-targeted HPV infections. The primary purpose of surveillance for HPV infections and associated conditions is to monitor potential impacts of the vaccination program. […] Surveillance data on HPV-associated cancers, including cervical cancer, are collected in 2 population-based central cancer registries NPCR and SEER which together collect data on cancers diagnosed in 100% of the US population.
#29 Common Warts Market Insights, Epidemiology and Market Forecasts, 2032 – ResearchAndMarkets.com
https://www.businesswire.com/news/home/20220314005507/en/Common-Warts-Market-Insights-Epidemiology-and-Market-Forecasts-2032—ResearchAndMarkets.com
Common Warts Epidemiology […] The Common Warts epidemiology division provide insights about historical and current Common Warts patient pool and forecasted trend for every seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the report also provides the diagnosed patient pool and their trends along with assumptions undertaken. […] […] […] The disease epidemiology covered in the report provides historical as well as forecasted Common Warts epidemiology scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France, and the United Kingdom), and Japan from 2019 to 2032. […] […] […] The epidemiology segment also provides the Common Warts epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.
#30 Post marketing surveillance for Microwave Treatment of Plantar and Common Warts in Adults | medRxiv
https://www.medrxiv.org/content/10.1101/2022.02.08.22270290v1
A handheld microwave device (Swift, Emblation Limited) has been licenced and available for clinical use since 2016 in the fields of podiatry and dermatology and has been extensively used in treating cutaneous warts. […] A total of 126 clinics responded (59.6%). 6998 adults (65 years) underwent wart treatment with microwave (81.9% plantar warts; 18.1% common, non-plantar warts). […] This survey of clinics using SWIFT microwave treatments reports on the effectiveness and safety of the device in the treatment of 8506 adult patients with common and plantar warts. […] Responding user clinics reporting efficacy with good clearance rates and low levels of adverse events demonstrating microwave is a safe and effective treatment for plantar and common warts.
#31 Post-marketing surveillance for Microwave Treatment of Plantar and Common Warts in Adults – Emblation
https://emblation.com/post-marketing-surveillance-for-microwave-treatment-of-plantar-and-common-warts-in-adults/
A handheld microwave device (Swift, Emblation Limited) has been licenced and available for clinical use since 2016 in the fields of podiatry and dermatology and has been extensively used in treating cutaneous warts. […] As part of post marketing surveillance by the manufacturer, an online 79-item survey was distributed to podiatry clinics in the United Kingdom with a Swift device. […] A total of 126 clinics responded (59.6%). […] 6998 adults (65 years) underwent wart treatment with microwave (81.9% plantar warts; 18.1% common, non-plantar warts). […] The median efficacy rate was reported as 79.2% (65.9 87.5%) and 82.3% (71.4 100%) respectively. […] In older adults (over 65 years) efficacy rates were similar for both sites: plantar (73.2%, 50-90%, n=1232) and non-plantar (80.0%, 42.1-100%, n=276).
#32 Anogenital warts guide: Key information and resources – Canada.ca
https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/anogenital-warts.html
Anogenital warts (AGW) are common and contribute to significant healthcare utilization costs and adverse psychosocial effects. […] In recent years, AGW occurrence has decreased markedly in countries with HPV vaccination programs. […] AGW are not a nationally notifiable condition in Canada.
#33 Anogenital warts guide: Etiology and epidemiology – Canada.ca
https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/anogenital-warts/etiology-epidemiology.html
A systematic review found that, 5 to 8 years after vaccination in high-income countries, diagnoses of AGW decreased by 67% among girls aged 15 to 19 years, by 54% among women aged 20 to 24 years, and by 31% among women aged 25 to 29 years. In parallel, diagnoses of AGW decreased by 48% among boys 15 to 19 years, and by 32% among men aged 20 to 24 years. […] A systematic review of studies published between September 1, 2006 and September 1, 2016 found that the incidence of AGW decreased by up to 45% in cohorts eligible for publicly funded quadrivalent HPV vaccines. A subsequent Manitoba study documented a decline in incident AGW of 72% among 16- to 18-year-old females and 51% among males after the introduction of a publicly-funded, school-based quadrivalent HPV vaccination program for females in 2008.
#34 The Common Warts Market Size is Anticipated to Increase at a Significant CAGR of 14.41% in the 7MM During the Study Period (2019-32)
https://www.prnewswire.com/news-releases/the-common-warts-market-size-is-anticipated-to-increase-at-a-significant-cagr-of-14-41-in-the-7mm-during-the-study-period-2019-32-301526981.html
As per DelveInsight, the total Common Warts prevalent cases were approx 2.7 million cases in the 7MM in 2020. […] Among EU5 countries, Germany has the highest Common Warts prevalence, while Spain had the lowest in 2020. […] Common Warts account for nearly 70% of all viral warts and are more common in school-aged children. Despite the high incidence rate, the Common Warts treatment landscape is limited and ambiguous. […] The key driver for the surge in Common Warts market size is the rise in the Common Warts prevalence in the 7MM. […] The current market landscape, governed with salicylic acid does not provide an opportunity for curing the warts, thus the recurrence is high. This challenge is dubbed as the Common Warts market driver for the continuing and future developmental activities for the indication. […] The expected launch of these therapies will fuel the Common Warts market size during the forecast period (2021-2032).
#35 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management
https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOorhCW-OnxcJyDsU-TGbDfAlAiMVZCx-bLBPurZ2TDZyar0rKfJt
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 exhibit an annual incidence of 14% in the general population. […] Risk factors center about increased exposure to HPV, increased risk of epidermal barrier penetration, and inappropriate immune responses. […] It is estimated that 40% of the population is infected with HPV, and in 7% to 12%, a wart develops. […] Two percent of the adult population and 6% of the pediatric population seek care for a plantar wart annually. […] Plantar warts occur most frequently in children and adolescents, although they are rare in patients younger than 5 years. […] Two of the most significant risk factors for developing plantar warts are (1) having a preexistent wart and (2) having close contact with someone who has a preexistent wart.
#36 Common Warts – Epidemiology Forecast – 2032
https://www.researchandmarkets.com/reports/5633021/common-warts-epidemiology-forecast-2032?srsltid=AfmBOoojjhHZ2-Rx_7D4WTO3xMc4VwPuiOposj-Ft_tuh2H0cKzvcRGc
Among 7MM + China, the United States had approximately 2,805,077 diagnosed prevalent cases of Common Warts in 2021, which was equivalent to 13% of total diagnosed prevalent cases in 7MM + China. […] In 2021, the EU-5 accounted for approximately 10,761,864 diagnosed prevalent cases of Common Warts, which are expected to increase by 2032 at a CAGR of 0.2%. […] As per The 's assessment, among 7MM + China, China recorded highest diagnosed prevalent cases of Common Warts with approximately 6,894,784 cases in 2021, which was equivalent to 32% of total diagnosed prevalent cases in 7MM + China. […] In 2021, Japan had 1,365,220 diagnosed prevalent cases of Common Warts ranking lowest among the 7MM + China. These cases are expected to decrease by 2032 at a CAGR of -0.4% during the forecasted period (2022-2032). […] Based on the literature review, it can be concluded that Common Warts can affect male and female equally. A very slight difference was observed between the both genders in the 7MM + China.