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 immunoresponsiveness to prevent recurrence.

Best outcomes are achieved with a combination of destructive and immunosensitising 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.

Warts are elevated, round, hyperkeratotic skin papules with a rough greyish-white or light brown surface. Although lesions may occur anywhere, they have a tendency to occur at sites prone to trauma, such as knees and elbows. Filiform warts have a stalk-like appearance with multiple spikes.[1]James WD, Berger T, Elston D. Andrews' diseases of the skin: clinical dermatology. 10th ed. New York, NY: W.B. Saunders; 2006.[2]Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006;4:273-293. http://www.clinmedres.org/content/4/4/273.full http://www.ncbi.nlm.nih.gov/pubmed/17210977?tool=bestpractice.com