These are very common, infectious epidermal papules, caused by one of the many types of human papillomavirus (HPV). They may appear on people of all ages, however, the highest prevalence has been reported for school-age children. Their appearance and size depends on their location and the extent of exposure to mechanical irritation and injury. The course of disease is individual. The infection may have a character of a single or multiple eruptions, while the process itself may spread by self-infection.
Common warts - popular papules and nodules with a keratotic and papillomatous surface, of 2-10 mm diameter, of dome-shaped round or irregular appearance, rough and firm to the touch, in light grey, yellow, brown or grey black colour. They are most common on the body sites mostly exposed to injury (fingers, elbows, knees, face, scalp). They may also appear around the fingernails as periungual warts.
Plantar warts - pushed inwards, hyperkeratotic nodules, found particularly over the pressure areas of the feet (sole), and therefore flattened, usually painful, more often as a single or few lesions, covered with a rough, keratinized epidermis. Frequently, when scratching the surface of warts, they start bleeding. When plantar warts join up to form large plaques on the feet, they form so called mosaic warts, which are more flat and painless.
Flat warts (juvenile warts) - flat, noninflammatory, usually flush with the skin's surface, commonly found on the face and the dorsal part of the hand. On the face, they are slightly brownish or skin-coloured, on the hands they might be slightly raised and hyperkeratotic. Flat warts may persist over a period of several months and then they might disappear in very characteristic way, preceded by sudden reddening and swelling of all the lesions, which causes that many patients consult their doctors. Awareness of these symptoms is important, as it means that self-healing will take place over the next few days and no treatment is required.
Common warts are not associated with the development of cancer. Only a few types of viruses may cause cancerous growths, predominantly in the cases of urogenital area and in immunodeficient patients. Viral warts should be removed. The treatment should be started as soon as possible, carried out effectively with minimal side-effects. Then we increase the chances of successful local therapy, reduce the possibility of auto-infection and spreading of the lesions. The procedure depends upon the location of warts, their type, their extensiveness, duration, the patient's age of his/her immunity. The treatment is primarily local. It concerns mechanical removal, electrocoagulation, laseroterapy or cryotherapy. In some cases, before removal of larger warts, the hyperkeratotic accumulation of the
lesion is softened with 10% salicylic acid topical cream.
Definitely, the best and most effective treatment method for getting rid of warts is their vaporization with CO2 laser. The therapy leads to elimination of the lesion, however, it might happen that it will need to be repeated after a few weeks. Sometimes, it is enough to remove a few warts, for the remaining lesions to disappear spontaneously.
They are hard, half-transparent lesions, which are flesh-coloured, dome-shaped, and pearly in appearance, with a central depression whose core may be expressed, producing a white cheesy material. Etiology of the lesions - viral (high contagiousness among children).
Incubation period lasts from 2 to 7 weeks. Most cases occur in children and in immunodeficient patients. The papules are typically rather small - 2-5 mm in diameter.
Most often found on the skin of hands, face, genital area, but they may also occur in other parts of the body - including mucous membranes.
The lesions are removed either by scraping them off with a curette, with local anaesthesia or during CO2 laser therapy.