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
AYM has received funds in the following roles: as an advisory board member for Janssen and LEO Pharma; as a consultant for Allergan, Biofrontera, Bristol-Myers Squibb and Mayne Pharma; as a clinical study investigator for AbbVie, Aclaris, Allergan, Astellas Pharma, Biofrontera, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant Sciences, Dermira, Eli Lilly and Company, Foamix Pharmaceuticals, Galderma, Incyte, Janssen, Mayne Pharma, Naked Biome, Novartis, Parexel, Pfizer and Verrica Pharmaceuticals; as a coordinating investigator for Allergan; and as a speaker for AbbVie, Aclaris, Allergan and Almirall.
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
More DifferentialsGuidelines
- British Association of Dermatologists’ guidelines for the management of cutaneous warts 2014
- British Association of Dermatologists' guidelines on the efficacy and use of acitretin in dermatology
More GuidelinesPatient leaflets
Warts (common)
HPV (human papillomavirus) vaccine
More Patient leaflets
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer