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==Types of wart==
==Types of wart==
A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved.<ref>''Mosby's Medical, Nursing, & Allied Health Dictionary'' (5th edn), Anderson KN, Anderson LE, Glanze WD, eds, Mosby</ref> These include
A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved.<ref>''Mosby's Medical, Nursing, & Allied Health Dictionary'' (5th edn), Anderson KN, Anderson LE, Glanze WD, eds, Mosby</ref> These include
*'''common wart''' (''Verruca vulgaris''), a raised wart with roughened surface, most common on hands and knees;
*'''[[common wart]]''' (''Verruca vulgaris''), a raised wart with roughened surface, most common on hands and knees;
*'''[[Verruca plana|flat wart]]''' (''Verruca plana''), a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees;
*'''[[Verruca plana|flat wart]]''' (''Verruca plana''), a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees;
*'''[[filiform wart|filiform or digitate wart]]''', a thread- or finger-like wart, most common on the face, especially near the eyelids and lips;
*'''[[filiform wart|filiform or digitate wart]]''', a thread- or finger-like wart, most common on the face, especially near the eyelids and lips;

Revision as of 07:00, 11 November 2008

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Wart
SpecialtyDermatology Edit this on Wikidata
A filiform wart on the eyelid.

A wart (also known as verruca) is generally a small, rough tumor, typically on hands and feet but often other locations, that can resemble a cauliflower or a solid blister. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV) and are contagious when in contact with the skin of an infected person. It is also possible to get warts from using towels or other objects. They typically disappear after a few months but can last for years and can recur.

Types of wart

A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved.[1] These include

  • common wart (Verruca vulgaris), a raised wart with roughened surface, most common on hands and knees;
  • flat wart (Verruca plana), a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees;
  • filiform or digitate wart, a thread- or finger-like wart, most common on the face, especially near the eyelids and lips;
  • plantar wart (verruca, Verruca pedis), a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet;
  • mosaic wart, a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet;
  • genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata), a wart that occurs on the genitalia.

Treatment

Prescription

Two viral warts on a middle finger, being treated with a mixture of acids (like salicylic acid) to remove them. A white precipitate forms on the area where the product was applied.

Treatments that may be prescribed by a medical professional include

  • Application of podophyllum resin paint [podophyllum resin I.P.'66 (20% w/v), benzoin I.P. (10% w/v), aloes I.P. (2% w/v), isopropyl alcohol I.P. to make (100% v/v)]
  • Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers ("immunomodulators"), or formaldehyde, often with mechanical paring of the wart with a pumice stone, blade etc.[2];
  • Cryosurgery, which involves freezing the wart (generally with liquid nitrogen), creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin falls off by itself;
  • Surgical curettage of the wart;
  • Laser treatment;
  • Imiquimod, a topical cream that helps the body's immune system fight the wart virus by encouraging interferon production;
  • Injection of Candida, mumps, or Trichophyton antigens at the site of the wart, which stimulate the body's immune system[3];
  • Cantharidin, a chemical found naturally in many members of the beetle family Meloidae which causes dermal blistering.

The wart often regrows after the skin has healed.

One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75% observed with salicylic acid compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants.[4] The reviewers also concluded that there was little evidence of a significant benefit of Cryotherapy over placebo or no treatment.[4]

Over-the-counter

There are several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid or a bottle of concentrated salicylic acid solution. Removing a wart with salicylic acid requires a strict regimen of cleaning the area, applying the acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a wart.

Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing.

Duct tape occlusion therapy

Main article: Duct tape occlusion therapy

Duct tape occlusion therapy (DTOT) involves placing a piece of duct tape over the wart(s) for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. There is conflicting evidence as to whether or not DTOT is an effective wart therapy.

The study cited above[5] had 9 patients lost to the follow-up from the original 61 patients entered. In contrast to the flaws (15% of subjects lost to the follow-up) and favorable results of the above study, a more stringent study of 103 children found no benefits from duct tape[6] . The evaluators were blinded during treatment for the most part, a placebo (corn pad) was used and there were no patients lost to the follow-up. After six weeks, rates of wart resolution were similar in the duct tape and corn pad groups and much lower than the rates seen in the earlier trial.

A similar trial comparing duct tape with a control treatment with a moleskin pad in 90 adults also found no difference in the rate of wart resolution at the end of two months (21 versus 22 percent).[7] However, the median age in this study was 54 years, and transparent duct tape was used, which contains no rubber found in the standard gray variety.[8]

See also

Look up wart in Wiktionary, the free dictionary.

References

  1. ^ Mosby's Medical, Nursing, & Allied Health Dictionary (5th edn), Anderson KN, Anderson LE, Glanze WD, eds, Mosby
  2. ^ Warts at About.com
  3. ^ Horn TD, Johnson SM, Helm RM, Roberson PK (2005). "Intralesional immunotherapy of warts with mumps, Candida, and Trichophyton skin test antigens: a single-blinded, randomized, and controlled trial". Arch Dermatol. 141 (5): 589–94. doi:10.1001/archderm.141.5.589. PMID 15897380.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ a b Gibbs S, Harvey I, Sterling JC, Stark R (2003). "Local treatments for cutaneous warts". Cochrane Database Syst Rev (3): CD001781. doi:10.1002/14651858.CD001781. PMID 12917913.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Focht DR, Spicer C, Fairchok MP (2002). "The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart)". Arch Pediatr Adolesc Med. 156 (10): 971–4. PMID 12361440. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) lay-summary
  6. ^ de Haen M, Spigt MG, van Uden CJ, van Neer P, Feron FJ, Knottnerus A (2006). "Efficacy of duct tape vs placebo in the treatment of verruca vulgaris (warts) in primary school children". Arch Pediatr Adolesc Med. 160 (11): 1121–5. doi:10.1001/archpedi.160.11.1121. PMID 17088514.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Wenner R, Askari SK, Cham PM, Kedrowski DA, Liu A, Warshaw EM (2007). "Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial". Arch Dermatol. 143 (3): 309–13. doi:10.1001/archderm.143.3.309. PMID 17372095.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ "Study: Duct tape wart cure overstated".
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