Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- lesion growth over weeks to months
- round, raised papule
- tiny black dots on surface of lesion
Other diagnostic factors
- satellite lesions
- fingers or nail fold lesions
- facial lesions
- fissuring
- hyperkeratosis
- greyish-white or light brown colour
- filiform papule with sharp spikes
Risk factors
- water immersion
- occupations involving handling of meat or fish
- nail biting
- age under 35 years
- immunocompromised
Diagnostic investigations
1st investigations to order
- no initial test
Investigations to consider
- skin biopsy
- immunoperoxidase stain
- skin culture
Treatment algorithm
common wart: immunocompetent
common wart: immunocompromised
filiform wart
Contributors
Authors
Angela Yen Moore, MD
Director
Arlington Center of Dermatology
Primary Investigator
Arlington Research Center
Arlington
Clinical Assistant Professor
Baylor University Medical Center
Dallas
Clinical Assistant Professor
University of Texas Medical Branch
Galveston
TX
Disclosures
Dr. Moore receives funds as an advisory board member (A), consultant (C), clinical study investigator (I), and speaker (SP) – for Abbvie (I,SP), Almirall (C,I,SP), Arcutis (I), Biofrontera (C,I), Boehringer Ingelheim (I), Bristol-Myers Squibb (C,I), Dermavant (I), DS Biopharma (I), Eli Lilly (I), EpiHealth (A), Evolus (A), Galderma (I), Incyte (I), Janssen (I), Leo (A,SP), Mayne Pharma (C,I), Nimbus (I), Novartis (I), Parexel (I), Pfizer (I,SP), UCB (I), Verrica (I), Vyne (I,SP).
Acknowledgements
Dr Angela Yen Moore would like to gratefully acknowledge Dr Leonid Izikson, the previous contributor to this topic. LI declares that he has no competing interests.
Peer reviewers
Brenda L. Pellicane, MD
Dermatologist
Wayne State University School of Medicine
Department of Dermatology
Detroit
MI
Disclosures
BLP declares that she has no competing interests.
David Cassarino, MD, PhD
Assistant Professor
Department of Pathology and Laboratory Medicine
University of California
Los Angeles
CA
Disclosures
DC declares that he has no competing interests.
Jashin J. Wu, MD
Chief Dermatology Resident
University of California
Irvine
CA
Disclosures
JJW declares that he has no competing interests.
Sam Gibbs, FRCP
Consultant Dermatologist
Dermatology Department
The Great Western Hospital
Swindon
UK
Disclosures
SG declares that he has no competing interests.
Differentials
- Flat warts
- Palmoplantar warts
- Seborrhoeic keratosis
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