Warts (HPV)
Symptoms
Common warts are rough, flesh‑colored papules with pinpoint dots (thrombosed capillaries). Plantar warts may be painful when walking and appear flat due to pressure. Flat warts are smooth, slightly raised, and often numerous on the face or backs of hands. Filiform warts project as thread‑like growths, typically on eyelids or lips. Warts can cluster into mosaic patterns.
Cause
Human papillomavirus infects keratinocytes through microscopic skin breaks. Different HPV subtypes favor specific body sites. Viral replication induces epidermal hyperplasia, forming the wart. Transmission occurs via direct contact or contaminated surfaces. Immunocompromised individuals develop more extensive or persistent lesions.
Treatment
First‑line therapy includes topical salicylic acid combined with mechanical debridement. Cryotherapy with liquid nitrogen destroys wart tissue. Immunotherapy using imiquimod or 5-Fluorouracil boosts local immune clearance. Preventing autoinoculation by not picking and keeping skin moisturized reduces spread.
Dr. Beth Schulz-Butulis
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