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Common warts

Last reviewed: 7 Apr 2025
Last updated: 30 Oct 2024

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
Full details

Other diagnostic factors

  • satellite lesions
  • fingers or nail fold lesions
  • facial lesions
  • fissuring
  • hyperkeratosis
  • grayish-white or light brown color
  • filiform papule with sharp spikes
Full details

Risk factors

  • water immersion
  • occupations involving handling of meat or fish
  • nail biting
  • age under 35 years
  • immunocompromised
Full details

Diagnostic tests

1st tests to order

  • no initial test
Full details

Tests to consider

  • skin biopsy
  • immunoperoxidase stain
  • skin culture
Full details

Treatment algorithm

ACUTE

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006;4:273-293.Full text  Abstract

Gibbs S, Harvey I, Sterling J, et al. Local treatments for cutaneous warts: systematic review. BMJ. 2002;325:461.Full text  Abstract

Kwok CS, Gibbs S, Bennett C, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012;(9):CD001781.Full text  Abstract

Dall'oglio F, D'Amico V, Nasca MR, et al. Treatment of cutaneous warts: an evidence-based review. Am J Clin Dermatol. 2012;13:73-96. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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