What are warts? Who might get warts? What are the types of warts? What causes warts and are they contagious? What are the symptoms of warts? How are warts diagnosed? How are warts managed or treated? What are the complications of warts? How can I prevent warts?

Overview

What are warts?

Warts are noncancerous (benign) rough bumps that form on the skin. They develop when the human papillomavirus, or HPV, enters a cut or break in the skin and causes an infection.

Who might get warts?

Children are more prone to warts because they get a lot of cuts. Still, anyone can get warts. People with autoimmune disease or weakened immune systems, including the elderly, are more susceptible to the virus that causes warts.

What are the types of warts?

Wart types vary depending on the affected body part. Types include:

• Hands: These warts are called common warts because they are the most common type.
• Face: Flat warts affect the face and forehead.
• Feet: Plantar warts appear on the soles of the feet. These warts look like calluses with tiny black dots in the center. They are often painful and form in clusters.
• Genitals: Warts that form on the penis, vagina or rectum are called genital warts. These warts are a type of sexually transmitted infection. You get genital warts through sexual contact with an infected person.
• Periungual and subungual: These warts form under or around fingernails and toenails.

Symptoms and Causes

What causes warts and are they contagious?

When the human papillomavirus (HPV) enters a cut in the skin, it causes a skin infection that forms warts. Warts are very contagious. The virus can spread from person to person or from different parts of the body through:

• Direct contact with a wart.
• Touching something contaminated with the virus, such as towels, doorknobs and shower floors.
• Sexual intercourse (genital warts).
• Nail biting and cuticle picking.
• Shaving.

What are the symptoms of warts?

Warts vary in appearance. They may look:

• Dome-shaped.
• Flat.
• Rough.
• Skin-colored, brown, grey or black.

Diagnosis and Tests

How are warts diagnosed?

Your doctor can diagnose warts simply by looking at the bumps. Sometimes, your doctor may take a sample of the skin growth (biopsy) to test for HPV.

Management and Treatment

How are warts managed or treated?

Warts often go away on their own after your immune system fights off the virus. Because warts can spread, cause pain and be unsightly, your doctor may recommend treatment. Options include:

• At-home wart removal: Over-the-counter (OTC) wart removal medications, such as Compound W®, contain salicylic acid. This chemical dissolves warts one layer at a time. These products come in liquid, gel and patch form. You may need to apply the medication every day for several months to get rid of the wart completely.
• Freezing: During a procedure called cryotherapy, your doctor applies liquid nitrogen to freeze the wart. After freezing, a blister forms. Eventually, the blister and wart peel off. You may need several treatments.
• Immunotherapy: For stubborn warts that don’t respond to traditional treatments, immunotherapy helps your immune system fight the virus. This process involves a topical chemical, such as diphencyprone (DCP). DCP causes a mild allergic reaction that makes the wart go away.
• Laser treatment: Your doctor uses laser light to heat and destroy tiny blood vessels inside the wart. The process cuts off blood supply, killing the wart.
• Topical medicine: Your doctor may apply a liquid mixture containing the chemical cantharidin. A blister forms under the wart and cuts off its blood supply. You must return to your doctor’s office in about a week to have the dead wart removed.

What are the complications of warts?

Most warts go away without any significant problems. Sometimes warts cause issues, such as:

• Cancer: HPV and genital warts are linked to several different cancers, including anal cancer, cervical cancer and throat (oropharyngeal) cancer. You can lower your risk of genital warts by getting the HPV vaccine and using condoms.
• Disfigurement: People with weakened immune systems may develop unappealing clusters of warts on the hands, face and body.
• Infection: Infections can occur if you pick or cut a wart. Breaks in the skin allow bacteria to enter.
• Pain: Most warts don’t hurt. But plantar warts can grow inward into the foot and be painful to walk on. You may feel as if there’s a pebble under the skin.

Prevention

How can I prevent warts?

There’s really no way to prevent warts. However, you can lower your risk of picking up the virus or stop warts from spreading by taking these steps:

• Avoid shaving over a wart.
• Break the habit of biting your nails or picking at cuticles.
• Don’t share towels, washcloths, clothing, nail clippers, razors or other personal items.
• Don’t touch another person’s wart.
• Get the HPV vaccine and use condoms to prevent genital warts.
• Keep your feet dry to prevent the spread of plantar warts.
• Try not to scratch, cut or pick at a wart.
• Wear flip-flops or shoes when using a public locker.

HPV, Causes, Types, Treatments, Removal, Prevention

Overview

What are warts?

Warts are noncancerous (benign) rough bumps that form on the skin. They develop when the human papillomavirus, or HPV, enters a cut or break in the skin and causes an infection.

Who might get warts?

Children are more prone to warts because they get a lot of cuts. Still, anyone can get warts. People with autoimmune disease or weakened immune systems, including the elderly, are more susceptible to the virus that causes warts.

What are the types of warts?

Wart types vary depending on the affected body part. Types include:

• Hands: These warts are called common warts because they are the most common type.
• Face: Flat warts affect the face and forehead.
• Feet: Plantar warts appear on the soles of the feet. These warts look like calluses with tiny black dots in the center. They are often painful and form in clusters.
• Genitals: Warts that form on the penis, vagina or rectum are called genital warts. These warts are a type of sexually transmitted infection. You get genital warts through sexual contact with an infected person.
• Periungual and subungual: These warts form under or around fingernails and toenails.

Symptoms and Causes

What causes warts and are they contagious?

When the human papillomavirus (HPV) enters a cut in the skin, it causes a skin infection that forms warts. Warts are very contagious. The virus can spread from person to person or from different parts of the body through:

• Direct contact with a wart.
• Touching something contaminated with the virus, such as towels, doorknobs and shower floors.
• Sexual intercourse (genital warts).
• Nail biting and cuticle picking.
• Shaving.

What are the symptoms of warts?

Warts vary in appearance. They may look:

• Dome-shaped.
• Flat.
• Rough.
• Skin-colored, brown, grey or black.

Diagnosis and Tests

How are warts diagnosed?

Your doctor can diagnose warts simply by looking at the bumps. Sometimes, your doctor may take a sample of the skin growth (biopsy) to test for HPV.

Management and Treatment

How are warts managed or treated?

Warts often go away on their own after your immune system fights off the virus. Because warts can spread, cause pain and be unsightly, your doctor may recommend treatment. Options include:

• At-home wart removal: Over-the-counter (OTC) wart removal medications, such as Compound W®, contain salicylic acid. This chemical dissolves warts one layer at a time. These products come in liquid, gel and patch form. You may need to apply the medication every day for several months to get rid of the wart completely.
• Freezing: During a procedure called cryotherapy, your doctor applies liquid nitrogen to freeze the wart. After freezing, a blister forms. Eventually, the blister and wart peel off. You may need several treatments.
• Immunotherapy: For stubborn warts that don’t respond to traditional treatments, immunotherapy helps your immune system fight the virus. This process involves a topical chemical, such as diphencyprone (DCP). DCP causes a mild allergic reaction that makes the wart go away.
• Laser treatment: Your doctor uses laser light to heat and destroy tiny blood vessels inside the wart. The process cuts off blood supply, killing the wart.
• Topical medicine: Your doctor may apply a liquid mixture containing the chemical cantharidin. A blister forms under the wart and cuts off its blood supply. You must return to your doctor’s office in about a week to have the dead wart removed.

What are the complications of warts?

Most warts go away without any significant problems. Sometimes warts cause issues, such as:

• Cancer: HPV and genital warts are linked to several different cancers, including anal cancer, cervical cancer and throat (oropharyngeal) cancer. You can lower your risk of genital warts by getting the HPV vaccine and using condoms.
• Disfigurement: People with weakened immune systems may develop unappealing clusters of warts on the hands, face and body.
• Infection: Infections can occur if you pick or cut a wart. Breaks in the skin allow bacteria to enter.
• Pain: Most warts don’t hurt. But plantar warts can grow inward into the foot and be painful to walk on. You may feel as if there’s a pebble under the skin.

Prevention

How can I prevent warts?

There’s really no way to prevent warts. However, you can lower your risk of picking up the virus or stop warts from spreading by taking these steps:

• Avoid shaving over a wart.
• Break the habit of biting your nails or picking at cuticles.
• Don’t share towels, washcloths, clothing, nail clippers, razors or other personal items.
• Don’t touch another person’s wart.
• Get the HPV vaccine and use condoms to prevent genital warts.
• Keep your feet dry to prevent the spread of plantar warts.
• Try not to scratch, cut or pick at a wart.
• Wear flip-flops or shoes when using a public locker room, pool area or showers.

Outlook / Prognosis

What is the outlook (prognosis) for people with warts?

Once you have the virus, there’s no sure way to keep warts from returning. After treatment, warts can reappear at the same location or a different part of the body. But some people get rid of warts and never have one again.

Living With

When should I call my healthcare provider about warts?

You should call your provider if the wart:

• Breaks open often, increasing the risk of infection or virus spread.
• Causes embarrassment.
• Develops on the genitals or rectum (genital warts).
• Itches.
• Looks infected (red or pus-filled).
• Makes walking painful and difficult (plantar warts).

What questions should I ask my healthcare provider about warts?

If you or your child has warts, consider asking your provider:

• How did we get warts?
• How can we keep warts from spreading to other parts of our bodies?
• What steps can we take to prevent getting more warts?
• What steps can we take to ensure other family members don’t get infected?
• What’s the best treatment for the warts?
• Should I look out for any signs of complications?

Warts can be unsightly and embarrassing. The good news is that warts often go away on their own. They also respond well to treatment. The virus that causes warts spreads easily. Be sure to take the necessary steps to prevent warts from infecting other people or other parts of your body. Your doctor can recommend the best at-home or in-office treatment to get rid of warts.

Symptoms, Causes, and Treatment for Plantar Warts

Plantar warts are those that develop on the bottom of the foot (known as the plantar surface). Caused by the human papillomavirus (HPV), these abnormal but benign growths of skin affect the uppermost layer of skin, known as the epidermis.

A plantar wart can spread if you touch, scratch, or pick at it. Some can develop into widespread clusters on one or both feet, only to spontaneously resolve after months or years.

Marionette / Wikimedia Commons / CC BY-SA 3.0

Depending on its location, a wart can sometimes press against sensitive tissues and nerve endings, causing pain and discomfort. While anyone can get a plantar wart, they most typically affect children, teens, and young adults.

Some smaller growths can disappear on their own without treatment, and others can often be treated at home with an over-the-counter wart remover. Those that are larger or especially painful may require medical treatment, including cryotherapy or surgical excision.

Verywell / Gary Ferster

Plantar Wart Symptoms

Plantar warts are similar in appearance to corns but are differentiated by their location and structure. While corns are commonly found on the top surfaces of the smaller toes (particularly over a joint), plantar warts tend to develop on the heel or weight-bearing parts of soles.

When trimmed back, a plantar wart will have characteristic black dots where enlarged capillaries have hardened. With time, or sometimes even initially, several plantar warts can appear in a grouping.

Plantar warts can often grow inward due to the pressure placed on them when you walk or stand. These warts have grainy, finger-like fibers surrounded by a hardened callus. Inward-growing warts and those located in the skin folds of the toes tend to be the most painful.

Larger plantar warts sometimes split, exposing sensitive tissue and triggering pain and bleeding.

Causes

All warts are caused by HPV, the same virus associated with genital warts, of which there are more than 100 strains. The type primarily associated with plantar warts is HPV-1. Less common culprits include HPV types 2, 4, 60, and 63, among others. 

When infected with HPV, the epidermal cells will begin to multiply rapidly, leading to the formation of a verruca (wart). Those found are the soles of the feet are commonly referred to as verruca.

The virus thrives on moist surfaces and can be easily transmitted through tiny breaks in the outermost shell of the epidermis, known as the stratum corneum.

After infection, a wart may not develop for several weeks or months. However, once the wart is established, the virus can move from the initial overgrowth to adjacent breaks in the skin.

Not everyone exposed to HPV will develop a wart. People with compromised immune systems, such as those with HIV, are especially vulnerable. Feet that sweat heavily or are regularly exposed to moist surfaces, such as a locker room floor, are also more likely to get warts.

Diagnosis

Plantar warts are typically diagnosed by the appearance of the skin growth. If in doubt, your doctor may trim the growth to see if there are any of the black dots among the fibrous tissues.

If the growth is extensive or atypical, a skin scraping (shave biopsy) may be performed and sent to the lab to check for other similar conditions, such as molluscum contagiosum, squamous cell carcinoma, or a tuberculosis-related complication known as verrucosa cutis.

Treatment

Most plantar warts can be treated at home if they are small and non-intrusive. However, you should always see a doctor if a wart is bleeding, affecting how you walk, is changing in texture or appearance, or is worsening despite treatment.

This is especially true if you have diabetes since even a small wart can trigger extreme neuropathic pain or lead to a diabetic foot infection.

Home Remedies

There are numerous over-the-counter (OTC) wart treatments, most of which contain salicylic acid. Some are applied topically with a dropper or swab, while others are applied over the wart with an adhesive bandage. There are even aerosol sprays that can gradually freeze and kill the affected tissue.

Other people rely on the duct tape method, a harmless yet questionable practice in which duct tape is repeatedly applied to a wart to gradually “strip away” the abnormal tissue.

The success of OTC treatments depends largely on the size of the wart and how consistently the treatment is applied. Larger warts tend to be less responsive to OTC treatments.

If using a salicylic acid-based product, it always helps to debride the dead skin cells between treatments with a callus file or pumice stone. Try not to be too aggressive, as this can lead to bleeding, pain, and the formation of a boil or abscess. Be sure to clean the skin thoroughly after debridement, as well as your hands and debridement tools.

Prescriptions

Recalcitrant (treatment-resistant) plantar warts may benefit from a topical 5% 5-fluorouracil (5-FU) cream. Available by prescription, 5-FU cream proved effective in a small 2006 clinical trial when used with the duct tape method. Of the 20 people included in the study, 19 experienced complete eradication after 12 weeks.

A 2009 study investigating the use of 5-FU in treating pediatric warts demonstrated an efficacy of 41%.

The 5% 5-FU cream is currently approved for the treatment of solar keratosis and a type of skin cancer known as basal cell carcinoma. At present, the drug is used off-label for the treatment of warts and should only be used under the direction of the dermatologist.

The cream is typically applied twice daily for a duration determined by your doctor and may cause mild redness, peeling, and a burning sensation.

Medical Procedures

Based on the appearance of your wart, your doctor may recommend a prescription-strength salicylic formulation to apply at home. If this doesn’t help, there are several in-office procedures that may deliver faster and safer results.

Among them:

• Cryotherapy involves the use of liquid nitrogen to freeze and kill the affected tissue. While generally safe when performed by a doctor, it may require several treatments.
• Trichloroacetic acid is a stronger acid that needs to be applied by your doctor. As with cryotherapy, it may take several visits to completely remove the wart.
• Pulsed-dye laser therapy is sometimes used to cauterize (burn) the wart. There is usually significant pain following the procedure. It may also require several treatments performed every three to four weeks.
• Electrosurgery and curettage involve the use of an electrocautery device and a tool called a curette to scrape off the dead cells. The procedure requires a local anesthetic and tends to cause significant post-operative pain.
• Bleomycin is a chemotherapy drug occasionally used off-label with electrosurgery to treat recalcitrant plantar warts. A small study conducted in 2017 reported that a local injection of bleomycin combined with electrosurgery resulted in a 78% eradication rate compared to 16% with bleomycin alone. 
• Surgery is the most direct means of treatment, requiring a local anesthetic and a scalpel to excise the wart. Sutures are usually needed. To avoid infection and the reopening of the wound, you may need to stay off your feet for several days.
• Cantharidin is a blistering agent not approved for use in the United States that is known to cause a blister beneath a wart when injected. This effectively separates the wart from the rest of the skin, causing it to dry up and die.
• Immunotherapy involves the use of a drug, such as diphencyprone (DCP), that spurs the immune system to eradicate the HPV infection. It is generally reserved for severe cases. It may cause an allergic response, including anaphylaxis.

Prevention

Gardasil, Gardasil 9, and Cervarix, the three vaccines used to prevent genital warts, are unable to prevent plantar warts as they target different HPV strains (specifically, types 6, 11, 13, 16, 18, 31, 33, 45, 52, and 58).

To this end, you need to reduce your risk by maintaining good foot hygiene and covering your feet in places where people walk barefoot. If you get professional pedicures, be sure to visit a salon that maintains good cleaning habits (such as sanitizing basins after each use or using tub liners) and consider bringing your own tools.

If you have a plantar wart, change your shoes and socks regularly to avoid the spread of the virus. Always wash and dry your feet thoroughly and use a little talcum powder to help absorb excess moisture and perspiration.

What Causes Foot Warts? | Cincinnati Foot & Ankle Care

Common warts are small growths on the skin caused by a viral infection. When a wart appears on the bottom of your foot, it is referred to as a plantar wart. Warts are contagious and can spread from one person to another. Most plantar warts usually go away without treatment or through self-care. However, you may opt to seek treatment from a licensed podiatrist to ensure the wart is taken care of effectively.

Symptoms

The common symptoms of plantar warts are:

• Rough and fleshy skin growths or lesions on the base of the toes or the heel
• Formation of thickened skin or callus where a wart has grown inward
• Tiny black dots which are actually clotted blood vessels
• Pain and discomfort when walking or standing due to growths on the foot

Foot warts can either be solitary or mosaic. A wart is solitary when only a single wart appears on the foot. Mosaic warts are a cluster of warts that show up in the same area of the foot.

Cause of Foot Warts

Plantar warts are caused by HPV or Human Papillomavirus. This particular virus may enter your body through breaks or tiny cuts on the bottom of your feet. When skin cells become infected with HPV, it makes the cells grow quicker, resulting in the formation of warts.

Everyone responds differently to HPV, and while it is contagious, not everyone who gets the virus will develop warts. Nonetheless, it can thrive and spread quickly, especially in warm and wet environments.

That said, the following groups of people are at a higher risk of developing foot warts or coming in contact with HPV:

• People who have occupations that require them to walk around barefoot and are exposed to communal areas, such as athletes, gymnasts, swimmers, and dancers.
• People with sweaty feet.
• People who share shoes or unwashed socks with other people.
• People who have a weak immune system.
• People who have skin-to-skin contact with someone who has foot warts or HPV.

When Should You Seek Treatment?

Although warts aren’t considered a serious health concern, it can be painful and uncomfortable to deal with. You should also consult your doctor if:

• The wart is bleeding or there is a change in color and appearance.
• The wart is causing discomfort that is a hindrance to your daily activities.
• You have a weakened immune system or immune system disorders.
• You’ve been trying to treat the wart, but treatment hasn’t helped or if the wart has multiplied.

Foot Warts Treatment in Cincinnati

There are a variety of ways to treat foot warts. However, using over-the-counter medications is not advisable because it doesn’t penetrate the thick skin on the sole of the foot. This causes them to rarely be effective enough to prevent the wart from returning.

If you want to remove your plantar warts, consult with a podiatrist for the proper treatment. Here at Cincinnati Foot & Ankle Care, we offer a variety of procedures to eliminate your foot warts, such as:

• Burning the wart with topical acid
• Freezing the wart with liquid nitrogen
• Laser surgery
• Surgical excision

Our podiatrists provide the latest, most appropriate, and comprehensive care for your foot care needs. We are dedicated to assisting you in regaining your health and living a pain-free life.

To arrange a consultation, call our location nearest you. You may also request an appointment online.

Infected & blood warts | Wartie

Warts are caused by viral infections, though they sometimes are accompanied by pus and blood, which is caused by bacteria. Treating a wart with pus usually involves the use of topical or oral antibiotics, and occasionally, your GP will recommend a combination of both.

Warts containing pus are highly contagious, and the infection can easily spread to other people and to different parts of the body. Also call the GP if a wart or the skin around it is:

• Painful
• Red
• Bleeding
• Swollen
• Oozing pus

Hot compresses should be applied to a wart with pus to facilitate healing and to promote the drainage of pus. A wart with pus should never be lanced at home in an attempt to drain the pus, because this could worsen the infection and cause it to spread. A hot compress can be applied several times a day, however, a clean compress should be used each time to avoid reintroducing bacteria to the area. Symptoms of a wart with pus can also include inflammation at the site, redness, pain, and an increase in temperature over the area. Fever, chills, and body aches can also occur if the infection becomes systemic.

The colour of pus can vary and can range from a light straw colour to dark brown, or even black. Red or pink pus is caused by the combination of blood and pus, however, this does not indicate a more serious infection than pus without blood. Also, pus can be watery in consistency, or thick and sticky. Again, the consistency or amount of pus is not a reflection of the seriousness or type of infection.

If a wart with pus begins to drain on its own, the area should be gently washed with mild soap and warm water. An over-the-counter antibacterial ointment can then be applied, and the area should be covered with a sterile bandage. If the wart continues to drain pus, it should be kept covered to avoid spreading the infection, and you should notify your GP.

Painful verruca

Verrucas are plantar warts found particularly over the pressure areas of the feet (heel and ball). They may cause pain, particularly with walking. Occasionally leg or back pain may result from altered posture or gait disturbance. A wart on the sole of the foot is more likely to cause discomfort than warts in other areas such as the hands. Pain is reason to consider treatment. If you have a plantar wart and also have diabetes or another medical condition that makes you prone to infections or slow to heal, see your doctor. A plantar wart can get infected. In people with diabetes, foot infections do not heal easily.

Warts in Children | Johns Hopkins Medicine

What are skin warts in children?

Warts on the skin are harmless growths. They are caused by a virus. Warts can spread to other parts of the body and to other people.

What causes skin warts in a child?

Warts are caused by a type of human papillomavirus. Different types of warts are caused by different types of papillomavirus.

Which children are at risk for warts?

Warts are more common in children than adults, but they can happen at any age. A person is more at risk for warts if he or she has either of these:

What are the symptoms of skin warts in a child?

Warts are usually not painful, except when one is on the bottom of a foot. There are many different types of warts. They each look different. The types of warts and their symptoms include:

• Common warts. These usually have a rough surface. They are grayish-yellow or brown in color. They may be on the fingers, elbows, knees, or the face.

• Plantar and palmar warts. These grow on the soles of feet or the palms of the hand. Groups of plantar warts are called mosaic. These warts may be painful.

• Flat warts. These are small, smooth growths. They most often appear on children’s faces.

• Filiform warts. These are small, long, narrow growths. They usually appear on eyelids, lips, or the face or neck.

• Periungual warts. These appear as thickened skin around the nails. They can cause painful splits in the skin (fissures).

Plantar Warts

This condition occurs when a virus enters the body through cuts or breaks in the skin and causes non-cancerous growths to build up on the soles of the feet. Plantar warts are not dangerous, but they can be painful and resistant to treatment.

How are skin warts diagnosed in a child?

The healthcare provider will give your child a physical exam. A healthcare provider will usually diagnose warts based on their appearance. He or she may use a small blade to scrape away the top layers. There may be black dots beneath the top layers. These are tiny blood vessels that have clotted. Your child’s healthcare provider may recommend that your child see a skin specialist (dermatologist). The dermatologist may do a shave biopsy, although this is not commonly done. A very small amount of the wart is shaved and sent to the lab to be examined.

How are skin warts treated in a child?

Most warts go away in weeks or months with no treatment. Common warts can often be treated with over-the-counter products. Treatment of warts depends on:

• How long they have been in place

• Where they are on the body

• What type of wart they are

• How many of them are growing

Some treatment methods may cause pain and burning in the area treated. Talk with your child’s healthcare provider about which treatments would cause the least pain and work best for your child. Treatment may include one or more of the below:                      

• Putting salicylic acid or other medicines on the wart (topical irritants)

• Freezing the wart with liquid nitrogen

• Applying an electrical current to the wart (electrocautery)

• Cutting out (excising) the wart

• Removing the wart with laser surgery

What are the possible complications of skin warts in a child?

Warts may be difficult to treat and may return.

What can I do to prevent skin warts in my child?

Warts can spread to other parts of the body and to other people. It can be spread by skin to skin contact. It can be virus may be spread by towels or other personal items. You can help prevent the warts from spreading. Make sure your child:

• Doesn’t touch the wart to other parts of his or her body

• Doesn’t touch the wart to other people

• Doesn’t share anything that touches his or her wart, such as towels

• Wears socks or slippers if he or she has warts on the bottom of the feet

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has warts that:

Key points about skin warts in children

• Warts on the skin are harmless growths. They are caused by one of the human papillomaviruses. 

• Warts are more common in children than adults, although they can develop at any age.

• There are many different types of warts with different appearances.

• Most warts go away, without treatment, but it may take weeks or months.

• Warts can be treated with over-the-counter medicines. Other treatments may be prescribed by your child’s healthcare provider.

Recognize different types of warts

What are common warts?

Common warts, also known as verruca vulgaris, is a common dermatological condition that causes small, fleshy growths on the skin. They are most often found on the hands or fingers, but can also occur in any other non-genital location. Common warts are caused by an infection with certain types of human papillomavirus (HPV) – an umbrella term for a large group of viruses causing different conditions.

HPV is contagious, meaning common warts can be passed from person to person, whether through direct skin-to-skin contact or indirectly through contact with a surface or object that is carrying the virus. People with weakened immune systems and children are more at risk of developing common warts.

The condition is generally considered to be non-serious and will often clear naturally without treatment. However, if necessary, treatment options, including minor removal procedures and home remedies, are available.

Symptoms of common warts

Common warts are easy to recognize and differentiate from other warts, such as genital warts, filiform warts or plantar warts. They typically appear on the hands or fingers, though can appear in any non-genital location, including the knees, ankles, arms and legs. If you think that you may have common warts, try using the Ada app to find out more about your symptoms.

Common warts are generally:

• Small, raised skin growths
• Oval or round in shape
• Rough to the touch
• Hard around the edges and softer in the middle
• Speckled with small black dots or “seeds”

Good to know: The small black dots or spots in a wart are sometimes called wart “seeds”. However, these are not seeds at all, they are actually small blood vessels.

When to see a doctor

Medical attention should be sought if:

• Warts cause pain or change color
• Warts spread, do not respond to treatment or frequently recur
• The person has a weakened immune system
• There is uncertainty as to whether the growths are common warts or a different condition

What causes common warts?

Common warts are caused by infection with human papillomavirus (HPV). There are over 100 different types of HPV that a person can contract, each affecting one or several different areas of the body and causing various conditions.

HPV infects the skin through small cuts, scrapes or weak spots, with warts appearing approximately two to six months later.. The virus causes the protein keratin to develop in excess on the surface of the skin, resulting in the appearance of a wart.

Common warts are particularly prevalent in children and young adults, as well as people with weakened immune systems as a result of conditions such as HIV/AIDS, certain other severe and long-lasting medical conditions, receiving certain kinds of chemotherapy, or after procedures such as organ transplantation and the ensuing treatment.

HPV is contagious and is passed on through direct skin-to-skin contact or indirect contact with objects or surfaces. Damaged or wet skin is most likely to pick up the virus, meaning locations such as swimming pools and showers, especially public ones, are particularly common sources of infection.

Diagnosing common warts

In the majority of cases, a doctor or dermatologist will be able to diagnose common warts through a simple physical examination. If further confirmation is needed, a skin biopsy may be ordered. To do this, the top layer of a wart will be scraped off and sent to a laboratory for testing. This is a straightforward and minimally invasive procedure.

Common warts treatment

Common warts will often disappear without treatment, especially in childhood. However, common warts can also be persistent and last for a significant amount of time. They can sometimes be painful and unsightly, especially when they form in clusters. In these cases, treatment options are available.

Prescription wart treatments

Prescription wart treatments may be used in conjunction with home remedies or when home treatment options seem unlikely to clear the condition. The method chosen by the doctor or dermatologist will depend on the severity of the warts, the symptoms and the general health of the person.

Common treatments

• Salicylic acid: This is a popular method for treating warts. Salicylic acid works by gradually dissolving layers of the wart tissue, eventually resulting in total removal. It is generally applied to the wart as a gel or liquid. Though salicylic acid is also available in over-the-counter products, prescription varieties are typically stronger and more effective. Along with peeling away the surface of the warts, salicylic acid may also encourage the body’s immune system to combat the virus.
• Cryotherapy: Generally performed by a doctor or dermatologist, cryotherapy is a method of freezing warts using liquid nitrogen. After around a week, the resulting dead tissue can be sloughed off. Repeated cryotherapy sessions may be necessary.

Less common treatments

If the above options are ineffective, other, less common treatment methods may be used. These include:

• Trichloroacetic acid: This is a strong acid applied by a doctor or dermatologist to the warts.
• Immunotherapy: The affected person is given antigens, substances which encourage the body’s immune system to fight the wart itself. This treatment is generally reserved for those with recurring common warts.
• Electrosurgery: This method involves burning away the wart tissue using a specially designed heated needle. A local anesthetic will usually be required to numb the pain, and scarring is possible.
• Laser treatment: A laser is used to burn off the skin tissue and remove the wart. It is generally considered to be a last resort option due to the likelihood of scarring and the extended recovery time.

Home remedies and over-the-counter products for common warts

Given that common warts are generally non-serious, some people may choose to try and treat them at home, possibly after visiting a pharmacy, before seeking professional medical advice. Common techniques for doing this include:

• Salicylic acid products: Non-prescription salicylic acid products, such as plasters, gels and rubs, are available from most pharmacies. These salicylic acid products work in the same way as the prescription version, though may be less powerful. Repeated application will generally be necessary.
• Liquid nitrogen: Non-prescription liquid nitrogen products are generally available from pharmacies for application at home, usually in the form of a liquid or gel.
• Apple cider vinegar: A possible remedy is to mix two parts apple cider vinegar with one part water, apply this to the wart using a cotton ball, and leave the wart to soak in the solution for at least 20 minutes. Repeat this process until the warts have disappeared. Discontinue or consult a medical professional if you experience severe skin irritation or severe pain, and in case of any doubt, always consult a doctor first.

It can take a significant amount of time before home remedies make a difference, and they may not result in wart removal or cause side effects. If treatments prove ineffective or side effects are strong or worrying, seeking professional medical advice is recommended.

Common warts prevention

It can be difficult to fully avoid contracting common warts, and most people experience them at some point in their life. However, certain preventative measures can help reduce the risk. These include:

• Avoiding contact with other people’s warts
• Avoiding contact with clothing, objects or surfaces that may be carrying the virus, e.g. by wearing water shoes or flip-flops in a public pool or public showers

If a person already has warts, they should take steps to avoid spreading the virus to other areas of the body or to other people. They can:

• Avoid unnecessarily touching or scratching the warts
• Cover warts with a plaster, especially when swimming
• Wash the hands regularly, especially after contact with the warts
• Avoid sharing towels and clothing that may come in contact with warts

Common warts FAQs

Q: Are common warts contagious by touch?
A: The virus that causes common warts, human papillomavirus (HPV), is contagious. Children and people with weakened immune systems are particularly at risk of contracting HPV, which can be spread through skin-to-skin contact or through contact with an object or surface carrying the virus. The risk of contracting HPV is especially high in warm, wet conditions, such as those found at a swimming pool or in a locker room.

Q: Are common warts HPV?
A: Common warts are caused by infection with human papillomavirus (HPV), which is an umbrella term for over 100 types of viruses. Certain strains of HPV can cause common warts to develop on the hands, fingers and other non-genital areas of the body. Other strains of HPV can cause different types of warts to appear on different parts of the body, including sexually transmittable genital warts, or different conditions altogether, including, in rare cases, cervical cancer or anal cancer.

Q: Are common warts the same as genital warts?
A: No, common warts are not the same as genital warts. Though both types of wart are caused by the HPV group of viruses, the strains that cause each type are different and so are the methods of transmission. Unlike common warts, genital warts are spread through sexual contact, they are an STI/STD. Common warts cannot spread to the pubic area and genital warts cannot spread to the hands or other parts of the body. Read more about genital warts.

Q: Can you get a common wart on your arm?
A: Yes. Though common warts often develop on the hands or fingers, they can also appear anywhere else on the body other than the genital area.

Q: What is the difference between common warts and plantar warts?
A: Both common warts and plantar warts are a product of the human papillomavirus (HPV) group of viruses. Unlike plantar warts, however, common warts can develop anywhere on the body, though most typically grow on the hands and fingers. Plantar warts are found on the feet only.

Q: What is the difference between common warts and water warts?
A: Common warts are caused by infection with HPV. Water warts, also known as molluscum contagiosum, are caused by infection with the molluscum contagiosum virus. The infection causes small, painless raised bumps or lesions on the skin, which often appear in groups and typically clear up on their own.

Q: What kind of wart do I have?
A: If you are concerned about a wart or another skin condition, you can use the Ada app to find out more about your symptoms. To receive a confirmed diagnosis, however, it is necessary to see a licensed doctor.

Q: Do common warts bleed?
A: A common wart should not bleed unless it is scraped, scratched or injured in some way. If a wart bleeds without a clear cause or bleeds profusely after injury, it is important to consult a doctor without delay.

Q: Can common warts be painful?
A: While most warts do not cause pain, some can, especially if they grow in an area which is pressed on often, e.g. a fingertip. If a common wart is painful, it is recommended that you see a doctor to make sure it is not serious and to receive appropriate treatment.

Q: Can a common wart get infected?
A: A wart itself is the result of infection of the skin with HPV. Warts do not generally become infected with bacteria, unless they are scratched, cut or otherwise injured in some way. In such cases, it is possible that bacteria may enter the wart or surrounding area, and a bacterial infection may result, causing pain, discoloration and other symptoms. If you are concerned that a wart may be infected, it is advisable to consult a doctor.

Q: Should I be concerned about common warts during pregnancy?
A: No, infection with HPV should not pose any risk to your baby. As in any case of common warts, no treatment may be necessary, though options are available over the counter and from doctors.

Q: Does duct tape work on common warts?
A: Occasionally recommended as a home remedy for warts, duct tape has not been confirmed as an effective treatment. Research is conflicting, but some people believe that doing the following may help to get rid of a common wart:

• Covering the wart with a small piece of duct tape
• Removing the duct tape every three to six days and gently using an emery board or pumice stone on the wart
• Covering the wart with a fresh piece of duct tape about 10 to 12 hours later

Results may only be seen after a number of weeks, if at all. Duct tape can cause skin irritation, bleeding and pain when removed. It should never be used in sensitive areas, such as the underarms or face.

Q: What are the signs that a common wart is going away?
A: When it is clearing up, or “dying”, a wart may shrink and start to disappear. This may happen on its own or with treatment.

Q: What should I do if a common wart won’t go away?
A: If a wart does not go away after treatment with prescription and/or home remedies, it is recommended that you see a doctor to rule out other conditions and ensure that the most appropriate treatment is being used.

Other names associated with common warts

• Verruca vulgaris
• Palmar warts, sometimes misspelled as palmer warts

Plantar Warts Information and Available Treatments | Feet For Life

Plantar Warts

The common wart is known as verruca vulgaris. They are caused by a viral infection of the skin. This occurs as a result of direct contact with the virus. The warts are contagious and can spread to other parts of the body and to other family members. They do not spread through the blood stream.

Must Know About This

• Most are small, but can occur in clusters.
• Plantar warts usually don’t stick up above the skin as much as warts on the hand, partly because the pressure of walking presses them downwards.
• Home remedies and over-the-counter treatments do not work as effectively as a podiatrist’s treatment, which can include: freezing the wart off with liquid nitrogen, removing the wart with laser or surgery, or applying medicines to strengthen the immune system.

Good to Know About This

• A plantar wart is a non-cancerous viral infections in the top layer of the skin on the sole of the foot.
• Plantar warts are very contagious and can easily be transmitted from one person to another by coming into direct contact with a wart or with something – such as a locker room floor or a towel – that has been in contact with a wart.
• Although most plantar warts go away in about two years without treatment, they can cause irritation or minor pain and may be unsightly.

More About This

They occur more commonly in children than adults. When they occur on the bottom of the foot, they are called plantar warts. This name is derived from the location of the foot on which they are found; the bottom of the foot is called the plantar aspect of the foot. A common misconception is that plantar warts have seeds or roots that grow through the skin and can attach to the bone. The wart may appear to have a root or seeds, but these are in fact small clusters of the wart just beneath the top layer of the skin. The wart cannot live in any tissue except the skin. Moist, sweaty feet can predispose to infection by the wart virus. They can be picked up in showers and around swimming pools. They are not highly contagious, but being exposed in just the right situation will lead to the development of the wart. Avoiding contact in the general environment is nearly impossible. If a member of the family has the infection, care should be taken to keep shower and tile floor clean. Children who have plantar warts should not share their shoes with other people. Young girls often share shoes with their friends and this should be discouraged.

Diagnosis

The warts have the appearance of thick, scaly skin. They can occur as small, single warts or can cluster into large areas. These clustered warts are called mosaic warts. They often resemble plantar calluses. A simple way to tell the difference between a wart and a callous is to squeeze the lesion between your fingers in a pinching fashion. If this is painful, it is likely that the lesion is a wart. A callous is generally not painful with this maneuver but is tender with direct pressure by pressing directly on the lesion. Other lesions on the bottom of the foot that are often confused with plantars warts are porokeratoses and inclusion cysts.

Treatment

Chemical Treatment

Various topical acids are available. Most are salicylic acids of different strengths that are applied directly to the wart daily. The effectiveness of this treatment is completely dependent on patient compliance and proper debridement of lesions. We recommend weekly debridements by a specialist. It is very important to debride off all of the dead skin in order for acid applications to continue to be effective.

Laser treatment

Many different laser treatments are being discovered and utilized. Here are a few more common ones.CO2 Laser: Used to cut and vaporize the wart. There are many techniques. Cutting around the lesion will allow a complete excision of the wart while cauterizing the blood vessels. Defocusing the laser or making small streaks with the laser over the body of the wart will vaporize the lesion and create a mild burn or blister. This will evoke an immune response within the body which will help heal the wart from the inside out.

Pulse Dye Laser: A newer technology and offered by the Feet For Life Centers. The success rate is reported as high as 95%. The device emits a tiny but powerful pulse of light that is absorbed by the pigment within the red blood cells of the wart. The light is generated when the lasing medium, a concentrated dye, is stimulated by a flash lamp energy source. This light is then directed at the wart using a pencil-like hand piece. The absorption of the light by the cells of the wart results in the cutting off of the wart’s nutritional blood flow.

The pulsed dye laser is safe and effective because of its unique ability to selectively treat the wart without adversely affecting the surrounding skin. Patients generally require no anesthetic which means no painful injections prior to treatment. There is also no risk of scar formation or infection because the skin surface is not broken. The patients can pursue any activity the following day. Debridement prior to treatment is very important. Multiple treatments may be required.

* Pulse Dye is more effective if the wart(s) have not been treated with other prior methods. For more information on the Flash lamp Pulse Dye laser click below.

Surgical Treatment: Blunt dissection: Surgically cutting around the lesion. Punch biopsy can be used. Area will bleed post op. Local anesthesia is necessary. There is a risk of scarring.

Cryogenic Treatment: (liquid nitrogen) Applied with a probe or applicator directly to wart. Will create a burn and can scar. Good post op immune reaction.

Hyfercation: Using an electric needle to hyfercate the wart. The lesion will vaporize at certain settings and will burn at higher settings. Can be used as a cutting tool.

Needling: Repeatedly puncturing the lesion with a needle. This is followed often with an injection of cortisone into the wart.

90,000 Warts: varieties. All about the foot

Warts are a papillomavirus infection that causes benign skin neoplasms that look like a nodule or papilla. The disease is caused by the human papillomavirus (HPV). At the moment, more than a hundred varieties (types) of HPV are known: some types of HPV are harmless, others cause warts, and others affect the genitourinary organs.

The human papillomavirus, which causes the development of warts, is transmitted through direct contact with an infected person, as well as through common items.

Infection is facilitated by irritation and microtrauma of the skin – warts often occur along the course of scratches, cuts, etc. Tight and synthetic shoes can also cause micro-trauma (chafing of the feet) and plantar warts. And the appearance of warts after visiting the pool is due to the fact that the skin is easily damaged by concrete protrusions and irritated by chlorinated water. Decreased immunity and chronic stress also increase the risk of papillomavirus warts.

Types of warts

Warts, as a rule, form on the face, on the skin of the hands and feet, and under the nails. Depending on the type of human papillomavirus and the clinical manifestations of the disease, three types of papillomavirus warts are distinguished:

• Common (vulgar) warts, especially common in school-aged children. Up to 71% of all skin warts are they. They are sharply limited, grayish-white, dense, painless, lumpy hemispherical nodules that rise above the level of the skin.Their surface can be covered with papillary growths in the form of cauliflower. They usually appear on the back of the hands and fingers or on the face. If left untreated, many white spots will develop around them, which can eventually turn into brown plaques. As a result, warts can cover the entire face, becoming a source of serious anxiety for a person.
• Plantar warts caused by papillomavirus appear in places of pressure from shoes, especially in people who sweat heavily – they account for about 34% of the total number of skin warts.Plantar warts that are very dense, keratinous, gray-dirty in color are severely sore, preventing walking, and can grow from a small plaque a few millimeters in to a hen’s egg.
• Flat, or juvenile, warts mainly affect children and adolescents. Less common (4%). They look like round or irregular flat nodules of grayish-yellow color, quickly keratinizing. The most sensitive areas of the hands and feet are affected – the back of the palms, between the fingers, around and under the nails, as well as the skin of the face and neck.Flat warts often develop along the course of scratches and cuts.

Except for the cosmetic consequences of their growth, warts do not particularly bother the sick person. An exception to this rule is when the wart grows under the nail, causing constant pain, and plantar warts.

When the skin is damaged, the warts grow easily. This can happen if they are located in areas that are often injured – for example, when shaving.

A dermatologist diagnoses a papillomavirus disease and prescribes treatment.

Today, the treatment of papillomavirus warts is to remove them. There are quite a few methods for removing warts. The most commonly used for this purpose are cryotherapy, laser therapy and electrocoagulation.

Sources

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• Klukas J., Pudszuhn A., Kusch K., Obermueller T., Hofmann VM. [Dermatomyositis as a paraneoplastic syndrome of head-neck-cancer: Case series & amp; literature review]. // Laryngorhinootologie – 2021 – Vol – NNULL – p .; PMID: 33906244
• Ríos M., Chiesa P., Arhcilles S., Cuesta A., Moltedo JM. [Use of ivabradine for the treatment of congenital junctional ectopic tachycardia]. // Medicina (B Aires) – 2021 – Vol81 – N2 – p.293-296; PMID: 33906151
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Laser wart removal in the Nearmedic network of clinics

Causes of the appearance and types of warts

A wart differs from a mole in a lighter color, from a papilloma – in that it does not have a leg, and from all other skin formations caused by a papillomavirus – a keratinized surface, hard and rough to the touch.The transmission of HPV, which causes the appearance of these skin growths, occurs by contact – through microtraumas on the skin when using items of clothing, household, hygiene of an already infected person.

The carrier of the virus may not have neoplasms, but he still serves as a source of infection. Self-infection is possible by combing or traumatizing neoplasms with clothing and transferring the virus to clean skin areas. Plantar warts can appear in the presence of microtraumas on the legs after visiting a public bath, sauna, pool without protective shoes.

Getting into the body initially, the virus can remain inactive for a long time. But with favorable factors, which include a decrease in immunity, frequent infectious diseases, hormonal disruption of HPV, embedded in DNA, it begins to infect nearby cells of the skin surface, provoking their involuntary division.

Warts are localized in a wide variety of areas of the body, most often on the fingers and toes, hands and feet, but can also appear on the face and soles.Depending on the etiology, pathogenesis and localization, the following types are distinguished:

• vulgar or common – located on the fingers and back of the hands, feet, toes, rarely on the face;
• plantar – located on the sole of the foot, can be painful when walking despite the thick stratum corneum;
• palmar – occur on the palms of people with excessive sweating, often – in adolescents and young men, the elderly;
• youthful, or flat – arise in the process of hormonal disruption, except for the skin of the hands and face, mucous membranes, including the genitals and rectum, may be damaged;
• subungual or periungual – the cause of the occurrence may be the habit of biting nails and the skin around the nail plate, violation of its integrity;
• threadlike – located on the skin of the face, neck, in the armpits, under the mammary glands, have an elongated shape, can be caused by hormonal changes during menopause;
• genital warts, or condylomas – are located in the perineum, on the genitals, in children – in the nasolabial folds.

Disposal methods

Depending on the location and type of warts, age, health status and other indications, the method of their removal is also selected. In cosmetology, the removal of these skin formations began a long time ago, so there are several proven ways to eliminate them:

• Surgical treatment – removal of especially overgrown and fusion neoplasms by means of their excision;
• cryodestruction – liquid nitrogen is used to treat formations for deep freezing with subsequent destruction;
• electrocoagulation – the use of a metal loop under a high frequency current, which cuts off the wart while simultaneously coagulating the blood vessels;
• laser removal of warts – exposure to a tuned laser beam, which evaporates only abnormal cells.

Excision with a scalpel, destruction with nitrogen and exposure to high-frequency current are fraught with the appearance of scars and scars of varying visibility that do not disappear over time. In addition to the absence of such consequences, the laser has additional advantages that are not observed with other procedures for removing neoplasms.

Advantages of laser treatment for wart removal

Compared to other procedures, the laser provides:

• inviolability of healthy tissues – vaporization concerns only pathological cells of the wart and the virus contained in them;
• exclusion of the formation of scars or scars after removal of the skin outgrowth;
• absence of bleeding and rapid healing of the treatment site;
• Regeneration of the natural process of skin renewal due to the production of hyaluronic acid, collagen and elastin fibers in the area of ​​exposure to the laser beam.

Erbium, dioxide or diode laser is used for the procedure.

Contraindications

One of the advantages of the procedure is the small number of contraindications, which are common to most therapeutic procedures:

• presence of other infectious diseases;
• oncological pathologies;
• chronic diseases in the stage of destruction;
• diabetes mellitus in the acute stage;
• various diseases of the blood;
• exacerbation of diseases of the circulatory system and / or hematopoietic organs;
• severe mental disorders, epilepsy;
• inflammatory process in the area of ​​exposure to the laser beam;
• pregnancy and breastfeeding;
• the presence of medical devices with metal parts in the body: pacemakers, pumps, implanted hearing aids.

Laser wart removal in NEARMEDIC

The network of NEARMEDIC multidisciplinary clinics provides a full range of services for the elimination of warts, including:

• consultation of a permanently practicing qualified doctor specializing in dermatologist-cosmetologist, dermatovenerologist, dermatologist;
• PCR diagnostics to determine the type of virus and differentiation of neoplasms;
• Removal of warts using a laser device of the latest generation;
• Antiviral drug therapy to prevent relapse;
• accompanying cosmetic procedures.

In NEARMEDIC cosmetology departments, the cost of laser wart removal is one of the most affordable in the capital among similar premium services. The price of the procedure depends on the location of the neoplasms, the area of ​​the lesion and additional cosmetic services, among which there may be:

• laser acne treatment;
• laser removal of age spots;
• Elimination of reticular veins on the face and extremities;
• removal of contagious molluscs and other neoplasms;
• lifting, etc.d.

Removal of benign skin lesions is carried out using innovative equipment. To eliminate warts, an apparatus of joint development in the field of laser cosmetology of specialists from Israel, Great Britain and the United States is used – IPL Quantum from Lumenis. Modification M22 – a high-intensity light source – belongs to the latest generation of equipment, which has the following advantages over other types of lasers:

1. Reduction of time and number of procedures due to increased efficiency due to high impact power.
2. Reliable protection of the skin surface from burns due to the unique cooling system.
3. Painlessness of the procedure thanks to the cooling system.

The use of a CO2 laser makes it possible to effectively remove neoplasms on the face, limbs and soles, and genitals in a non-contact manner.

If the procedure is required by a child or patient with hypersensitivity, the department uses medication sleep or effective local anesthesia.

Doctors cosmetologists-dermatologists of the network warn about the dangers of unprofessional manipulations to remove neoplasms in an accidental beauty salon, as this can cause serious complications up to malignant warts. The most harmless result of unprofessional removal is a relapse of the disease.

All specialists of the network’s cosmetology departments have basic medical education and are certified in the field of laser cosmetology. If necessary, the patient can be referred for examination to a dermatologist-oncologist.All patients have access to both histological and cytological examination in the NEARMEDIC laboratory equipped to the highest requirements in order to exclude cancer.

To prevent the recurrence of the appearance of warts, an effective immunomodulating and antiviral therapy is prescribed and carried out individually for each patient in order to eliminate the source of skin formations – the human papillomavirus.

Only such a comprehensive examination, laser removal and drug treatment can provide a lasting therapeutic effect.

To make an appointment with a dermatologist of the NEARMEDIC network of multidisciplinary clinics, call the NEARMEDIC contact center, a single telephone number for Russia, or use the feedback form on the website. To improve medical services, all patients of the clinic are given the opportunity to leave feedback on the process of cosmetological treatment on the site.

90,000 Viral papillomatosis in dogs – treatment, diagnosis, prevention

Papillomatosis is a viral disease caused by a microscopic DNA virus that does not have an envelope.

Viruses are the reason for the appearance of such formations. The disease is transmitted from a sick dog to a healthy one.

Viral papillomatosis – what is it?

Papillomas – proliferative, that is, germinating epithelial lesions, usually arising from the squamous epithelium of the skin or mucous membranes.

Many of these are caused by human papillomaviruses (PV) and are called viral papillomas, just like in humans.

Views

Difficulties usually do not arise in the diagnosis of viral papillomatosis in dogs.These growths are usually cauliflower-shaped, although they are also fringed or nodular, smooth, and sometimes look like cutaneous horns.

When papilloma is classic, biopsy is usually not required for a preliminary diagnosis. However, in ambiguous cases, research will resolve any questions.

The infection is transmitted through direct contact with an infected individual or, since it is resistant in the environment, through interaction with objects: toys, bedding, bowls.

The virus requires damaged skin to enter the body, healthy integuments do not lend themselves to infection.

The incubation period is 1 to 2 months. Recovered animals are not re-infected with the same strain.

Sometimes casula in the mouth is caused by bacteria in the mouth. In such cases, the inflammation will need to be treated with antibiotics and, if necessary, additional symptomatic therapy may be used to control pain, swelling, and bad breath.

Symptoms

The classic carrier of the disease is a young dog with warts in or around the mouth.

Symptoms of the disease are smooth, light pink, initially rounded capsules, which later develop into large irregular growths of the mucous membrane. There may be few of them, but in some cases they literally dot the mucous membrane of the cheeks, lips, gums, tongue and throat.

After many years of initial research, additional types have been identified.Cutaneous papillomas have been associated with CPV-1, 2, 6 and 7. Most develop in juveniles, presumably during the first papillomavirus infection.

Bumps on the skin can be single or multiple, they occur anywhere on the body.

Treatment of viral papillomatosis in dogs

Most breeders who are faced with such a problem ask themselves how to treat viral papillomatosis of dogs? Below we will try to analyze the problem in detail.

This is not necessary in most cases. Treatment of viral papillomatosis in dogs is not prescribed, since the neoplasms will disappear on their own over time. This is called disease regression.

Regression occurs due to the development of a cellular immune response. In experimentally induced warts, resolution usually occurs within 8 weeks. However, the disappearance of natural papillomas appears to be more variable, sometimes taking up to 12 months.

There are cases when a patient has so many capsules that the animal can refuse to eat. The tumors can then be removed surgically or cryogenically frozen.

After surgical treatment, the material is sent for histological examination to confirm the diagnosis.

Pigmented plaques often spontaneously regress, persist, or progress, affecting large areas of the skin. They are generally considered cosmetically undesirable but do not adversely affect your pet’s health.

Other types of papillomas:

• Cutaneous inverted (also called endophytic). They are caused by the CPV-2 virus. They appear as separate nodules on the abdomen (1 to 2 cm in size) with a small central pore or spread as a lumpy rash. Also appear between the toes;
• The second type is inverted, in which the lesions have a diameter of about 4 mm. They are flesh-colored domed rashes that may appear on the body.
• Papillomavirus Pigmented Plaques – Caused by several “Chinese dog papilloma viruses”, it commonly affects pugs and miniature schnauzers. They are dark, scaly, bumps of various sizes and are usually found on the abdomen. Unlike other species, they do not regress on their own, except in pugs.

Treatment of papillomatosis with novocaine

The most famous method of treatment is the administration of intravenous novocaine to a dog. The drug should be administered slowly.If the animal starts to fidget, you need to stop the medication and continue when it calms down.

Novocaine is a safe drug that has long been used in veterinary medicine. However, it is difficult to say whether this method of treatment is effective. Judging by the feedback from colleagues, it does not always work.

More effective is the use of antiviral drugs and interferonogens for both treatment and prevention.

Prevention

If your pet has bulky, multiple, sometimes bleeding growths on the body, and most often in the mouth or around the mouth, do not worry.In this case, it is recommended to consult a narrow-profile specialist and an inspection.

If frightening neoplasms are recognized as viral papillomatosis in dogs, you just have to wait for the time and the body will cope with them on its own. Surgical treatment is rarely used. The operative method is justified only in cases of deterioration in the patient’s quality of life.

Sometimes there are situations when the warts disappear, but the virus remains in the patient’s body. This can cause a number of complications: bleeding at the site of the growth, the degeneration of the wart into a cancerous tumor, the appearance of the infection again.If any of the above symptoms is observed in the dog, the animal must be urgently taken to the veterinary clinic.

If papillomas continue to appear on the animal’s body, you need to think about strengthening the immune system with the help of special food and a complex of vitamins.

90,000 The cause of cancer is a wart / Health / Nezavisimaya gazeta

It is impossible to get rid of the papilloma virus, but you can make its life unbearable

Only a specialist can determine the degree of danger of moles and warts.Photo Depositphotos / PhotoXPress.ru

According to the World Health Organization, more than 60% of the world’s population is infected with the human papillomavirus. Moreover, some people are only its carriers, while others have visible signs of a pathological process on the skin or mucous membranes – papillomatosis.

This process is characterized by the appearance of papillomas on any part of the skin or mucous membrane, which are also called warts in everyday life.They are localized on the body in different places, including on the face. Thus, papilloma is a benign skin tumor that develops from the superficial epithelium and protrudes above its surface in the form of a papilla. The culprit of its appearance is a very common virus or, as it is usually called, the human papillomavirus (HPV).

What is the mechanism of papilloma formation? Once in the lower layer of the skin or mucous epithelium, for example, through cracks or small wounds on the skin, the virus begins to multiply rapidly.And then, being, in fact, an intracellular parasite, he begins his destructive work, the result of which is a change in the DNA of the cell. Thus, it turns from normal to abnormal or atypical.

Due to active reproduction, altered cells lead to the formation of papillomas or genital warts (genital warts). Outwardly, these multiple formations are flesh or close to it in color and are from 0.2 to 1 cm in size. They are located on a pedicle or on a wide base.Papillomas are usually painless, with the exception of those located on the palm and sole and, as a result, are subject to mechanical irritation.

The human papillomavirus has many strains that differ from each other in the degree of contagiousness (the property of infection to be transmitted from person to person) and pathogenicity (the ability to cause pathological changes on the skin and mucous membranes).

As for the infection with HPV, the transmission of infection is possible both through sexual contact and through everyday life.There is also a great danger of transmitting the virus to the newborn if the mother is infected. Infection is possible if hygiene rules are not followed, when, for example, several people use a towel or other personal belongings of one family member – an HPV carrier. In addition, HPV can be contracted in public places, such as swimming pools or baths, and even with a simple handshake. However, a healthy person with normal immunity is not afraid of the virus, since it will be destroyed by the protective cells of the immune system.

The incubation (latent) period from infection to the appearance of papillomas and genital warts ranges from several weeks to several months. Condylomas are papillary growths of mucous membranes in the places where the virus is introduced. These sites often include the vagina and vulva in women and the glans of the penis in men. There are cases of very long-term asymptomatic carriage of HPV. By the way, in women, HPV is more common than in men, and its manifestations in the fair sex are found only at the reception of a gynecologist.

What contributes to the activation of the virus? First of all, weakening of immunity, which occurs, for example, under the influence of colds, stress, exacerbation of chronic ailments of the genitourinary system and gastrointestinal tract, endocrine system disorders, sexually transmitted infections, as well as smoking, alcohol abuse. It should be noted that the growth of pathological formations is sometimes accompanied by bleeding and inflammation.

However, the most serious danger lies in the fact that some strains of the human papillomavirus have a high oncogenicity – the ability to cause the development of a malignant tumor. For example, a relationship has been established between the presence of certain HPV strains in the female body and cervical cancer. Therefore, it is important to consult a doctor in a timely manner, who will refer the patient to a laboratory for a special study called an HPV test. If a virus is detected, the doctor will prescribe antiviral and immunomodulatory drugs.As for the neoplasms themselves, they are usually removed with a scalpel, laser, or by deep freezing.

Special mention should be made of vaccinations against HPV, which has more than 100 varieties. There are two vaccines – Gardasil (produced in Holland) and Cervarix (produced in Belgium). With their help, the body develops immunity against several strains of the virus, including those that provoke the development of cancer. Vaccinations are recommended for adolescents before the first sexual intercourse, especially for girls 10-13 years old.According to experts, vaccination is advisable for young women under 26 years of age, if they have not been vaccinated. You can get vaccinated at the antenatal clinic or in the clinic at your place of residence, having previously consulted a doctor.

Unfortunately, vaccination is not yet included in the National Immunization Schedule. And one more thing: vaccination does not protect those who are already infected from disease!

To what has been said, we add that, unfortunately, no one is immune from HPV infection.In this case, you should know that you cannot completely get rid of HPV. Having become infected, a person remains the carrier of the virus for life. Therefore, it is difficult to overestimate the importance of prevention, the best means of which is a healthy lifestyle. It helps to strengthen the immune system and thereby prevent infection.

Removal of benign neoplasms with liquid nitrogen

Removal of neoplasms with liquid nitrogen

Removal of neoplasms with liquid nitrogen is a time-tested effective method of treatment.Many patients more often perceive neoplasms as cosmetic problems on the skin, and not as a disease, and they turn to a doctor late for help. Benign epithelial skin tumors differ in size, color, quantity, localization, but they are more often viral in nature or associated with self-medication. So many patients bandage skin tumors with female, horse hair, cut off with nail scissors, etc. This does not solve the problem, but creates an environment for the attachment of a secondary infection. Injured neoplasms grow faster, bother the owner, get wet, bleed, crust over, and are painful.It is much easier to see a doctor, excluding self-medication

Cryodestruction or liquid nitrogen removal

Liquid nitrogen – a chemical liquid with a temperature of -196 degrees, used to remove any neoplasm (warts, papillomas, moles, tumors). Removal with liquid nitrogen is practically painless, so there is no need to undergo anesthesia for each neoplasm.

After cryodestruction (removal with liquid nitrogen), the skin can be washed with detergents almost immediately, there is no need to make dressings, seal with a plaster.Sometimes during the first 3 days, potassium permanganate treatment is recommended. By the 3rd-7th day, the neoplasms after cryodestruction dry up and turn into a crust. By the 10-14th day, the crusts are rejected without scars, the skin color practically does not change.

When removing by this method, the doctor presses a cotton swab moistened with liquid nitrogen against the neoplasm. As a rule, the removed neoplasm becomes white, then it turns red and is rejected.

Advantages and Disadvantages of Liquid Nitrogen Removal:

Important: Advantages:

• No pain relief necessary (no need to inject)
• The method can be applied multiple times on the same neoplasm
• No bleeding after removal
• Rarely leaves scars
• Good results for small pedunculated lesions (papillomas)

Disadvantages:

• Cannot take a biopsy (analysis for microscopic examination) of a distant formation
• The need for repeated use of liquid nitrogen, especially in large neoplasms and in areas with a thick layer of the epidermis (on the palms and soles).

Removal of benign neoplasms with liquid nitrogen

Fibroepithelial polyps

Fibroepithelial polyp (papillomas) are benign neoplasms on the skin in the form of warty growths, rising above the skin level, with a wide base or on a leg, grayish or brown in color, with a diameter of 0.3 – 1.5 cm or more, round or irregular in shape … Most often located on the neck (along the lateral surface) and in large folds.The surface of the papillomas is villous or covered with easily detachable horny masses.

Fibroepithelial polyps have 50% of the world’s population, and in women during pregnancy they increase in number and size. In pregnant women, these neoplasms are often on the nipples, which is dangerous for breastfeeding for an unborn child.

Seborrheic keratosis

Seborrheic keratosis (syn.: Seborrheic wart, senile wart, basal cell papilloma) is the most common benign skin tumor.It usually develops in middle and old age from the epidermis. Its pathogenesis is not clear, but it is believed that this lesion develops from the cells of the basal layer of the epidermis or keratinocytes of the most superficial part of the hair follicle and is not associated with the human papillomavirus. In accordance with modern concepts, there is no connection between it and solar irradiation. It occurs mainly in elderly and senile people, but is often observed in young people, equally often in men and women.

The tumor develops very slowly, sometimes over several decades. Initially, a limited spot of yellowish or brown color appears, which gradually increases, sometimes reaching 4-6 cm or more in diameter. The surface of the stain gradually becomes covered with greasy crusts, which can be easily removed. Over time, the crusts become denser, but often retain a greasy surface, mottled with cracks. The thickness of the crusts can reach 1-2 cm. The tumor becomes yellow-brown, dark brown or black.Localization can be very diverse. The lesions can be single and multiple. In rare cases, keratosis can become malignant.

Removal of warts with liquid nitrogen

Warts are small, usually painless skin growths caused by the human papillomavirus (HPV).

More than 100 types of HPV are known. HPV attacks the top layer of the skin and usually enters the body through damaged skin. The virus causes rapid growth of the top layer of the skin, forming warts.

Most, but not all, of the warts are generally harmless and go away on their own within a few months or years. Warts can grow anywhere on the body. They are most common in children and young adults – so liquid nitrogen removal is especially effective for hard-to-reach wart habitats.

Sometimes warts can be disfiguring, especially if they grow on the face or hands and cause psychological discomfort to their owner, and some of them also itch and pain.

Warts can appear at any age. Infection occurs through the shoes of an infected patient (plantar warts), in swimming pools, baths, gyms with exercise equipment, in hairdressing salons through manicure accessories (periungual warts).

Vulgar warts

Vulgar warts are the most common type of warts in humans. Other names are simple or common warts.

Remember: the cause of the appearance of vulgar warts is the already known Human Papilloma Virus (type 2).

Infection occurs during childhood. The virus gets on the injured skin (abrasions, scratches in children) and penetrates the skin. While in the body, it gradually multiplies in the basal layer of the skin, and after a few months, ordinary warts appear.

Clinical manifestations of the disease are simple. On the skin of the fingers and on the back of the hands and feet, there are rounded elevations ranging in size from 3 to 10 mm, no more. In this case, a characteristic feature of this disease is the multiple nature of the rash.That is, next to one simple wart on the hand, a second, daughter, may soon appear, then another next, etc.

Another symptom that is characteristic of vulgar warts in most cases is the so-called kissing warts. This is their arrangement, when two simple warts appear on two adjacent fingers, opposite each other, in contact with each other when the fingers are closed.

Flat warts

Among all neoplasms caused by the human papillomavirus, flat warts are considered the most harmless.But this is only at first glance, sometimes leaving the problem without proper attention, a person gives a green light to further development, contributing to the spread of flat warts over a much larger area of ​​the body. Flat, or juvenile, warts usually grow on the face, hands, or feet. They are small 1-5 mm, have flat tops in the form of irregular nodules, and can be pink, light brown or light yellow. They occur mainly in children and adolescents. During the treatment of warts, the feet can and should be washed, because.because treatment with liquid nitrogen is not traumatic, does not open tissues, does not release the virus. It is advisable to use liquid tea tree oil soap. After rejection of warts on the feet, it is necessary to disinfect shoes, get rid of slippers, socks, stockings so that there is no reinfection.

Genital warts or genital warts

Sexually transmitted in 60% of cases through contact with an infected partner. This is the most common HPV infection (HPV types 6, 11, 16, 18, 42, 44, 54).Externally, genital warts are moist, soft, cauliflower-like nodules. They often ulcerate, turning into foul-smelling ulcers. Favorite localization – genitals (mucous membranes and skin folds). Nitrogen removal of a wart – is a painless removal without anesthesia followed by scar-free healing.

During the treatment of benign epithelial tumors of the skin and mucous membranes, after a blood test for HPV, the use of immunomodulators and antiviral drugs is indicated both on the skin and mucous membranes, and, if necessary, inside.

90,000 Human papillomavirus infection of the skin: new about the known

The skin is the largest and functionally versatile human organ. The condition of the skin is closely related to the function of all organs and systems of the body. So, somatic diseases, as well as viral and bacterial infections provoke the appearance of dermatological pathology and, accordingly, various medical, social and economic problems.

One of the most common infectious dermatological diseases caused by human papillomavirus (HPV) is known as skin papillomatosis, or warts. The latter differ in appearance, size and shape: they distinguish between ordinary (vulgar), plantar, flat and genital warts. The most common type – common warts – is more often diagnosed in young children, and the peak incidence occurs during adolescence. Common warts are single or multiple nodules of a round shape, grayish-pink or yellowish in color with papillomatous growths and hyperkeratosis, prone to merging into large foci.The favorite place of localization of this type of epithelial neoplasms is the dorsum of the hands and feet (Fig. 1).

Plantar warts look like limited dense painful formations of a round shape with pronounced horny layers and papillomatous growths. They are located mainly on the feet in the area of ​​the heels or at the base of the metatarsal head (Fig. 2).

Flat (juvenile) warts are represented by multiple flattened small nodules, slightly rising above the surface of the skin and localized on the face, the red border of the lips, the back of the hands and forearms (Fig.3).

Etiology
HPVs are a large group of viruses tropic to stratified squamous epithelium, the pathological effect on which leads to the appearance of warts – benign epithelial tumors of viral origin. Currently, there are more than 150 types of HPV known. In most cases, the occurrence of common warts is due to infection with genotypes 1, 2, 4, 27 or 57, while plantar neoplasms develop under the influence of genotype 3 or 10.The transmission of the pathogen is carried out from person to person through direct or indirect (through objects used by the carrier of HPV infection) contact; another type of spread of infection is autoinoculation (self-infection). After penetration into the human body, HPV begins to actively multiply in the surface layers of the skin; the incubation period lasts from 1.5 to 6 months.
In a number of cases, isolated HPV infection is not enough for the clinical manifestation of the disease: the pathological process, as a rule, is triggered by provoking factors, which include a decrease in immunological reactivity, psychological trauma, vegetative neurosis, acrocyanosis, increased sweating of the skin of the hands and soles.Lifestyle and normal daily activities can also provoke the appearance of skin growths. For example, fans of walking barefoot are prone to plantar warts; food workers who process meat or poultry are at high risk of developing warts on their hands; those who bite their nails or bite their fingers suffer from multiple periungual growths. Careful maintenance of personal hygiene can also play a cruel joke – the appearance of flat warts on the cheeks, chin and lower legs can be caused by shaving, epilation, cosmetic peeling (procedures in which damage to the skin is likely).In addition, people who actively visit the pool, gym, bathhouse, sauna, etc. are at risk.
As already mentioned, warts are more often observed in children and adolescents, however, the disease can manifest itself at almost any age. Another distinctive feature of these benign neoplasms is the ability to self-resolve. After prolonged persistence with minimally expressed concomitant perifocal inflammation or without it, the warts decrease in size, and then completely spontaneously disappear (this process can take from 3-4 months to several years in time).
Despite the fact that in most cases, warts seem to be completely harmless epithelial neoplasms, do not forget that the HPV that causes them can also provoke the development of squamous cell skin cancer and precancerous conditions.

Diagnosis
Diagnosis of this disease is usually based on clinical evaluation; biopsy is rarely required to confirm the diagnosis. Removal of a wart is often accompanied by the appearance of punctate bleeding due to damage to the capillaries of the papillary layer of the skin.When taking a biopsy and studying the histological picture, the growth of the epidermis with impaired keratinization, vacuolization of cells and hypertrophy of the papillary layer of the dermis is noted (Mavrov G. I., 2009).
With the seeming simplicity of detecting warts in some cases, it is necessary to conduct a thorough differential diagnosis with other diseases (senile keratosis, palmoplantar keratoderma, congenital nodosity of the fingers, squamous cell carcinoma). Calluses and calluses on the lower extremities, as well as lichen planus and angiokeratomas can sometimes be mistaken for common warts.

Treatment
Treatment of skin papillomatosis has a number of clinical features. For example, the discovery of new elements of epithelial proliferation in some cases is not an indication for the appointment of pharmacological therapy. In children, adolescents and pregnant women, the so-called expectant tactics can be used, since warts tend to self-limiting, and drug therapy does not affect the contagiousness of the virus. The results of observational studies indicate that in 50% of cases, common warts resolve on their own within a year, and in 2/3 of patients they disappear without treatment within 2 years.Therefore, if warts of small size, located in inconspicuous places and not causing significant inconvenience, are found in immunocompetent patients, expectant tactics can be applied. However, if warts interfere with daily functions or represent a noticeable cosmetic defect that can cause serious psychological discomfort and cause a lot of torment in both social and personal life, the appropriateness of the appointment of specific therapy should be considered.
The ideal treatment for benign epithelial proliferation is believed to be simple, inexpensive, and free of side effects. According to E. Mulhem et al. (2011), the simplest and most effective approach in topical treatment of warts is the prescription of drugs containing salicylic acid. The latter has a keratolytic effect and antimicrobial activity, due to which there is a slow destruction of the HPV-infected area of ​​the epidermis. In clinical practice, salicylic acid is used in various concentrations (from 15 to 60%), most often 15-26%.The advantages of using this OTC drug are its low cost, easy availability, good tolerance and minimal side effects. Salicylic acid has a large evidence base. A combined analysis of the results of 5 randomized controlled trials (RCTs) showed that the likelihood of recovery with this keratolytic for 6-12 weeks is 73% compared with 48% with placebo. Before applying salicylic acid, it is recommended to steam the skin on which the wart is localized, and then carefully treat the affected area with a pumice stone or an emery file.The application of the drug should be carried out directly on the wart, after which the treated area can be covered with adhesive tape. Repeat the application of the drug until the wart disappears completely, while the maximum duration of treatment should not exceed 12 weeks.
Another effective method of treating warts is cryotherapy, the essence of which is to freeze epithelial neoplasms with liquid nitrogen or other refrigerant. Cold exposure leads to the death of cells infected with HPV, tissue death and subsequent rejection of the treated wart.Before carrying out the cryodestruction procedure, it is recommended to remove sections of the keratinized epithelium with a sharp blade, especially in the upcoming treatment of plantar warts. The application of liquid nitrogen is carried out using a cryoapplicator or a cotton swab for 10 s (5 s for treating small neoplasms, 20 s for plantar warts) until a white areola with a diameter of 2 mm appears around the wart. The procedure should be repeated every 2-3 weeks for 3 months. Depending on the duration of exposure to liquid nitrogen, a distinction is made between aggressive and standard cryotherapy.The aggressive technique provides for a longer exposure to the neoplasm, which is of particular importance in case of extensive skin lesions or the removal of therapeutically resistant warts. In recent years, in order to increase the effectiveness of therapy, it is recommended to carry out a combined treatment using both salicylic acid and cryodestruction.
Currently, various drugs are additionally used to remove warts: silver nitrate, 5-fluorouracil, zinc, dinitrochlorobenzene, adhesive tape, podophyllin, intralesional immunotherapy, imiquimod, bleomycin, as well as photodynamic therapy and pulsed laser therapy.
The effectiveness of these drugs continues to be actively studied: over the past few years, the results of a number of interesting studies have been published. Thus, in the work of F. Pezeshkpoor et al. (2012) studied the effectiveness of trichloroacetic acid in the treatment of common warts. The patients who took part in the study (n = 62) were divided into 2 groups for application to problem areas of the skin with 80% or 35% trichloroacetic acid solution 1 r / week until the skin was completely cleansed; the maximum duration of therapy did not exceed 6 weeks.The effectiveness of the treatment was classified as follows: no changes (the number of warts did not change), insignificant (removal of <25% of neoplasms), average (removal of 25-75% of skin growths), good (destruction of> 75% of warts). Comparing the results of therapy in two groups, scientists confirmed the clinical superiority of a high concentration of the drug: in 46.7% of cases, the effectiveness of an 80% solution of trichloroacetic acid was regarded as good, while among those who used a 35% solution, only 12% of patients were able to achieve a similar result (p = 0.017).Despite the positive data obtained, the authors of the study did not come to an unambiguous conclusion regarding the advisability of the routine use of highly concentrated trichloroacetic acid, stressing that only a doctor, after carefully weighing the pros and cons, can make the necessary choice.
Sometimes, even with the appointment of adequate pharmacological treatment, warts continue to recur. In such cases, according to M.G Olguin-Garcia and colleagues (2015), isotretinoin should be used to treat therapeutically resistant flat warts.Scientists came to this conclusion after analyzing the results of their RCT. This study involved patients (n = 31) with flat facial warts that were resistant to treatment. Patients were randomized to receive isotretinoin (30 mg / day) or placebo for 12 weeks. The resistance of warts to therapy was determined as follows: if the use of 3 of the following drugs (retinoids, 5-fluorouracil, imiquimod, liquid nitrogen cryotherapy) for ≥3 years did not lead to complete removal of benign skin lesions, the warts were considered difficult to treat.At the end of the 12-week course of therapy, it turned out that all patients receiving isotretinoin completely got rid of flat warts on the face, while no such cases were recorded in the placebo group (p = 0.0001). Patients generally tolerated isotretinoin administration well, although in some patients, treatment with this drug was accompanied by the development of cheilitis. Thus, M.G. Olguin-Garcia et al. proved the high efficacy and safety of isotretinoin in the treatment of therapeutically resistant flat warts.
The feasibility of using a purified protein derivative of tuberculin in the treatment of resistant warts was analyzed by V. Saoji et al. (2016). This uncontrolled study involved patients (n = 61) with various types of warts (common, flat and plantar). The design of this trial included 4 courses of intralesional injection of 2.5 tuberculin units at 2-week intervals followed by follow-up for 6 months. It turned out that the effectiveness of intralesional immunotherapy with tuberculin was 76%, which allowed the authors of the study to conclude that it is advisable to use this type of therapy as an alternative method for treating therapeutically resistant warts.

Evidence-based medicine data
The feasibility of using various pharmacological agents for the treatment of warts of various localizations has been analyzed in several meta-analyzes and systematic reviews. For example, a group of researchers led by S. S. Kwok (2011) studied the effectiveness of a variety of topical agents. A meta-analysis of 77 RCTs presented by these scientists showed that the effectiveness of salicylic acid in removing warts was superior to that of placebo (hazard ratio – RR 1.60; 95% CI 1.15-2.24).Comparing the effectiveness of cryotherapy and placebo, the scientists obtained some discouraging data: applications of liquid nitrogen did not help get rid of warts (RR 0.89; 95% CI 0.27-2.92). But, after conducting a more thorough analysis and conditionally dividing cryotherapy into aggressive and standard, the researchers proved the superiority of aggressive tactics over a gentle approach (RR 2.06; 95% CI 1.20-3.52). A pooled analysis of the results of all RCTs showed that the cure rate with placebo was 23% (95% CI 5-73%), while with salicylic acid and liquid nitrogen this figure was significantly higher: 52% (95% CI 0-87% ) and 49% (95% CI 0-69%), respectively.However, the most effective methods were aggressive cryotherapy (54%; 95% CI 45-75%) and the combined use of salicylic acid and cryotherapy (58%; 95% CI 38-78%).
Experts of the Cochrane Collaboration did not stand aside from the active discussion of effective treatment regimens for warts and tried to do their bit to solve this problem. C. S. Kwok et al. (2012) published a systematic review of 85 RCTs (n = 8815), which analyzed the effectiveness of topical therapy for warts of various sites.Having carefully studied the results of studies involving the use of salicylic acid, the experts proved the high effectiveness of this drug in the treatment of warts of various localizations (RR 1.56; 95% CI 1.20-2.03). Comparing the effectiveness of salicylic acid in removing these benign neoplasms on different parts of the body, experts found that the drug is most active against warts localized on the hands (RR 2.67; 95% CI 1.43-5.01), and not on the legs (RR 1.29; 95% CI 1.07-1.55).A similar relationship was recorded in relation to cryodestruction of warts with liquid nitrogen: this type of therapy turned out to be more effective in removing skin growths localized on the upper extremities (RR 2.63; 95% CI 0.43-15.94), and not on the lower ones (RR 0.90; 95% CI 0.26-3.07). One RCT has shown the superiority of cryotherapy over salicylic acid and placebo, but only for the treatment of warts on the hands. The experts did not record significant differences in the effectiveness of cryodestruction performed with an interval of 2, 3, or 4 weeks.Representatives of the Cochrane Collaboration confirmed the higher effectiveness of aggressive cryotherapy compared to that of the traditional technique of the procedure (RR 1.90; 95% CI 1.15-3.15), and also noted a higher risk of developing adverse events when using an aggressive cryodestruction. Comparing the effectiveness of salicylic acid and liquid nitrogen therapy, scientists were unable to establish the superiority of either of these methods (RR 1.23; 95% CI 0.88-1.71). At the same time, the combined use of this keratolytic drug and cryotherapy made it possible to achieve more significant results than monotherapy with salicylic acid (RR 1.24; 95% CI 1.07-1.43; data from 2 RCTs; n = 328).The feasibility of intralesional administration of bleomycin remained unproven, while the effectiveness of dinitrochlorobenzene was 2 times higher than that of placebo (RR 2.12; 95% CI 1.38-3.26; data from 2 RCTs; n = 80). The likelihood of complete cure with duct tape did not differ from that for placebo (RR 1.43; 95% CI 0.51-4.05; data from 2 RCTs, n = 193). Conducting a meta-analysis of the results of RCTs that studied the effectiveness of intralesional and topical use of 5-fluorouracil, silver nitrate, pulsed dye laser, photodynamic therapy, imiquimod, for a number of reasons, experts were unable to process the test data and prove the feasibility of using these approaches.Thus, among the most varied methods for the topical treatment of warts, only salicylic acid and cryotherapy have been proven to be effective and safe.

Clinical Guidelines
In 2014, experts from the British Association of Dermatologists (BAD), led by J. C. Sterling, published a practical guide to the treatment of warts. The provisions of this guideline include the use of salicylic acid and cryodestruction as first-line therapy (Table 2).1). The provisions of this guideline also regulate the doctor’s actions in various clinical situations (Table 2).

Thus, warts are one of the most common skin manifestations of HPV. The BAD experts consider the administration of salicylic acid and cryodestruction to be the first line therapy in the treatment of common, flat and plantar warts.

Prepared by Lada Matveeva

Medicna newspaper “Zdorov’ya Ukrainy 21 storichchya” No. 21 (394), leaf fall 2016 p.

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Subungual wart ✓ Author’s articles of the Clinic of Podology

Plantar warts are caused by an aggressive viral infection – human papillomavirus.

Most of the world’s population (60-80%) is infected with HPV, but many are unaware of it. Because our immunity is able to suppress the activity of this virus.

With a decrease in general or local immunity, the viral infection begins its active activity: benign tumors from the epithelium appear on the skin of the feet and palms. The wart looks like a callus, an area of ​​hyperkeratosis that often rises above the surface of the skin or extends deep into the skin on the sole of the foot.

However, upon close examination, the papillary structure of these formations with black dotted elements (thrombosed vessels) is revealed.

Warts located under the nail plates are more difficult to treat. These formations interfere with the growth of the nail plates, progress very quickly and affect the nail bed, due to which the nails grow dystrophic. When removing such warts, there is a risk of damage to the nail bed, which will lead to scarring and the nail plate will not be able to form.

In our clinic, there was an interesting clinical case: a 43-year-old patient complained of a painful viral wart in the periungual zone of the 1st toe of the left foot, associated the occurrence of education with wearing model narrow shoes. I cleaned it myself, cut off the lesion within 2 years, which led to an increase in size.

During a joint examination with the surgeon, it was decided to remove the extensive wart by radio wave surgery using the Surgitron apparatus.When the marginal zone of the nail plate was excised for access to the removal of the wart, a tumor-like formation was exposed, which was located in the thickness of the nail bed.

The surgeon performed a deep excision of the element with subsequent histological examination.

After histological examination, it was concluded that the neoplasm is a dermatofibroma. It was decided not to surgically remove the part of the nail bed covered with a wart due to the possible scar formation.The treatment of the wart with the PinPointe laser was carried out strictly according to the treatment regimen.

At the site of the laser-treated area, a focus of hyperkeratosis was formed after 8 weeks. During podological treatment, the formed crust was removed.