Warts:Cutaneous warts are small, rough growths that are caused by…
Warts:Cutaneous warts are small, rough growths that are caused by infection of keratinocytes with human papilloma virus (HPV). They can appear anywhere on the skin but are commonly seen on the hands and feet.
A verruca (also known as a plantar wart) is a wart on the sole of the foot.
Consider Treatment if:
The wart is painful (for example on the soles of the feet or near the nails).
The wart is cosmetically unsightly (for example on the hands or face).
The person requests treatment, and the wart is persisting.
Cutaneous warts resolve with months or years without treatment
Treatment an be prolonged require numerous treatments and can have adverse effects e.g scarring
Treatment options- adults and older children
Topical salicylic acid (15–50%) applied daily for up to 12 weeks. For more information see the section on Topical salicylic acid.
Combination therapy with salicylic acid and cryotherapy (applying topical salicylic acid preparations between cryotherapy sessions once the scabbing from cryotherapy has resolved).
A shorter cryotherapy freeze (for example 5–10 seconds) or a weaker strength topical salicylic acid preparation (for example 17% or less) is recommended for plane warts on the back of the hands, as scarring is more likely to occur.
Plantar warts are difficult to treat and cryotherapy is unlikely to help — as pain caused by plantar warts is usually due to thickening of the skin regular paring can help make the feet more comfortable. Care should be taken when paring to avoid abrading the surrounding normal skin, as this may lead to spread.
consider previous Rx and patient choice
Cryotherapy with liquid nitrogen (usually carried out every 2 weeks until the wart is gone, up to a maximum of six treatments). Note, cryotherapy is only suitable for some older children who are likely to tolerate this treatment.
Hyperkeratotic lesions of the hand or feet e.g. Actinic keratosis, Bowen’s disease, Seborrheic keratosis, Knuckle pads, SCC, Focal palmoplantar keratoderma, Lichen planus, Angiokeratoma
Corns and Calluses
Referral to dermatology
person is immunocompromised
extensive areas of skin affected e.g. mosaic warts of hands and feet
Palmar and plantar warts: grow on the palms and the soles of the feet (verrucae). They often have central dark dots (thrombosed capillaries) and may be painful.
Mosaic warts occur when palmar or plantar warts coalesce into larger plaques on the hands and feet
Filiform warts: finger-like appearance and may have a stalk (more common on the face and neck).
Plane warts: usually round, flat-topped, and skin coloured or greyish yellow (common on the backs of hands).
Common warts: firm, raised papules with a rough surface that resembles a cauliflower (common on knuckles, knees, and fingers)
Periungual warts are common warts around the nails that can be painful and disturb nail growth — nail biting is a risk factor.
usually clinical diagnosis and further Ix not required
not harmful, will resolve without treatment
Warts are contagious, but the risk of transmission is thought to be low
how to reduce risk of transmission
How to reduce personal spread (auto-inoculation):
Not to restrict children from activities and sports
Patient information leaflets