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common wart
Etiology:
1) all warts are caused by human papilloma virus (HPV)
2) HPV types 1,2,3,4
Clinical manifestations:
1) generally painless papule or cluster of papules
2) skin-colored with black punctae on close inspection (capillary loops)
3) most frequently on the face & distal extremities
4) variably-sized 1 mm to 1 cm
5) firm, solid, nontender
6) dome-shaped papule or nodule
7) hyperkeratotic, corrugated surface
8) singular or clustered with satellite lesions from local spread
9) clusters may become dense & matted
Management:
1) watch & wait, most disappear with time
2) see verruca vulgaris (wart)
3) topical salicylic acid is treatment of choice for common warts that need treatment [4]
4) cryotherapy every 2 weeks is more effective than topical salicylic acid for common warts [5]
5) cantharidin 0.7% colloidal solution
6) duct tape [3]
a) occlusion of wart with duct tape
b) duct tape applied over wart & left for 7 days
c) after 7 days, remove tape, soak in water & debride wart with emery board
d) repeat process until wart disappears
e) most patients note results in 2-3 weeks
f) discontinue use if excess irritation of no results within 3 weeks
7) topical imiquimod 5%
Related
papillomavirus
General
verruca vulgaris (warts)
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 958
- Anderson, Advance/Laboratory June 2001, pg 91
- Prescriber's Letter 9(12):70 2002
Cryotherapy Versus Duct Tape for Treating Warts
Detail-Document#: 181216
(subscription needed) http://www.prescribersletter.com
- Rumor vs. Truth: Duct tape can eliminate the common wart.
Prescriber's Letter Nov 17, 2006
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 19.
American College of Physicians, Philadelphia 2009, 2012, 2022
- Bruggink SC et al.
Cryotherapy with liquid nitrogen versus topical salicylic acid
application for cutaneous warts in primary care: Randomized
controlled trial.
CMAJ 2010 Oct 19; 182:1624
PMID: 20837684