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07-SEPTEMBER-2008 03:17:44 - Wart For the Nintendo character, see Wart Nintendo. For toad warts, see parotoid gland. Warts Classification and external resources Warts on the big toe ICD-10 B07. ICD-9 078.1 DiseasesDB 28410 MedlinePlus 000885 eMedicine emerg/641 MeSH D014860 A filiform wart on the eyelid. A filiform wart on the eyelid. A wart is generally a small, rough tumor, typically on hands and feet but often other locations, that can resemble a cauliflower or a solid blister. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus HPV and are contagious when in contact with the skin of an infected person. It is also possible to get warts from using towels or other objects. They typically disappear after a few months but can last for years and can recur. Contents 1 Types of wart 2 Treatment 2.1 Prescription 2.2 Over-the-counter 2.3 Duct tape occlusion therapy 3 See also 4 References 5 External links Types of wart A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved.1 These include: common wart Verruca vulgaris: a raised wart with roughened surface, most common on hands and knees flat wart Verruca plana: a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees filiform or digitate wart: a thread- or finger-like wart, most common on the face, especially near the eyelids and lips plantar Seray Dervish wart verruca, Verruca pedis: a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet mosaic wart: a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet genital wart venereal wart, Condyloma acuminatum, Verruca acuminata: a wart that occurs on the genitalia. Treatment Prescription Two viral warts on a middle finger, being treated with a mixture of acids like salicylic acid to remove them. A white precipitate forms on the area where the product was applied. Two viral warts on a middle finger, being treated with a mixture of acids like salicylic acid to remove them. A white precipitate forms on the area where the product was applied. Treatments that may be prescribed by a medical professional include: Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers immunomodulators, or formaldehyde, often with mechanical paring of the wart with a pumice stone, blade etc.2 Cryosurgery, which involves freezing the wart generally with liquid nitrogen, creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin falls off by itself. Surgical curettage of the wart. Laser treatment. Imiquimod, a topical cream that helps the body's immune system fight the wart virus by encouraging interferon production. Injection of Candida, mumps, or Trichophyton antigens at the site of the wart, which stimulate the body's immune system.3 Cantharidin, a chemical found naturally in many members of the beetle family Meloidae which causes dermal blistering. The wart often regrows after the skin has healed. One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75% observed with salicylic acid compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants.4 The reviewers also concluded that there was little evidence of a significant benefit of Cryotherapy over placebo or no treatment.4 Over-the-counter There are several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid or a bottle of concentrated salicylic acid solution. Removing a wart with salicylic acid requires a strict regimen of cleaning the area, applying the acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a wart. Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing. Duct tape occlusion therapy Main article: Duct tape occlusion therapy Duct tape occlusion therapy DTOT involves placing a piece of duct tape over the warts for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. Evidence suggests that DTOT is more effective than cryotherapy,5 The study cited above 5 had 9 patients lost to the follow-up from the original 61 patients entered. In contrast to the flaws 15% of subjects lost to the follow-up and favorable results of the above study, a more stringent study of 103 children found no benefits from duct tape6 . The evaluators were blinded during treatment for the most part, a placebo corn pad was used and there were no patients lost to the follow-up. After six weeks, rates of wart resolution were similar in the duct tape and corn pad groups and much lower than the rates seen in the earlier trial. A similar trial comparing duct tape with a control treatment with a moleskin pad in 90 adults also found no difference in the rate of wart resolution at the end of two months 21 versus 22 percent7 . See also Look up Wart in Wiktionary, the free dictionary. Laryngeal papillomatosis Molluscum contagiosum Epidermodysplasia verruciformis References ^ Mosby's Medical, Nursing, Allied Health Dictionary 5th edn, Anderson KN, Anderson LE, Glanze WD, eds, Mosby ^ Warts at About.com ^ Horn TD, Johnson SM, Helm RM, Roberson PK 2005. Intralesional immunotherapy of warts with mumps, Candida, and Trichophyton skin test antigens: a single-blinded, randomized, and controlled trial. Arch Dermatol 141 5: 589-94. doi:10.1001/archderm.141.5.589. PMID 15897380. ^ a b Gibbs S, Harvey I, Sterling JC, Stark R 2003. Local treatments for cutaneous warts. Cochrane Database Syst Rev 3: CD001781. doi:10.1002/14651858.CD001781. PMID 12917913. ^ a b Focht DR, Spicer C, Fairchok MP October 2002. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris the common wart. Arch Pediatr Adolesc Med 156 10: 971-4. PMID 12361440. lay-summary ^ de Haen M, Spigt MG, van Uden CJ, van Neer P, Feron FJ, Knottnerus A 2006. Efficacy of duct tape vs placebo in the treatment of verruca vulgaris warts in primary school children. Arch Pediatr Adolesc Med 160 11: 1121-5. doi:10.1001/archpedi.160.11.1121. PMID 17088514. ^ Wenner R, Askari SK, Cham PM, Kedrowski DA, Liu A, Warshaw EM 2007. Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial. Arch Dermatol 143 3: 309-13. doi:10.1001/archderm.143.3.309. PMID 17372095. External links Wart photo library - Dermnet v d e Infectious diseases - Virus diseases A80-B34, 042-079 CNS Encephalitis/ meningitis DNA virus: Progressive multifocal leukoencephalopathy RNA virus: Subacute sclerosing panencephalitis - Lymphocytic choriomeningitis - Tick-borne meningoencephalitis unknown: Encephalitis lethargica Eye DNA virus: Cytomegalovirus retinitis Other RNA virus: Rabies - Myelitis: Poliomyelitis Post-polio syndrome - Tropical spastic paraparesis Skin and mucous membrane lesions DNA virus, Herpesviridae: Herpes simplex - Chickenpox - Herpes zoster - KSHV DNA virus, other: Poxviridae Smallpox, Monkeypox, Cowpox, Vaccinia, Molluscum contagiosum - exanthem Roseola, Fifth disease - HPV Wart RNA virus: exanthem Measles, Rubella - picornavirus Hand, foot and mouth disease, Foot-and-mouth disease Digestive system Hepatitis DNA virus: B RNA virus: A - D - C - E - G Gastroenteritis DNA virus: Adenovirus RNA virus: Rotavirus - Norovirus - Astrovirus - Coronavirus Respiratory system RNA virus, IV: Acute viral nasopharyngitis - Severe acute respiratory syndrome RNA virus, V: Influenza/Avian influenza - Human parainfluenza viruses - RSV - hMPV Other/varied: Infectious mononucleosis - Viral pneumonia Sexually transmitted DNA virus: HPV Genital warts, Cervical cancer RNA virus, retrovirus: HIV AIDS, AIDS dementia complex - Adult T-cell leukemia Oncovirus DNA virus: Hepatitis B - HPV - Kaposi's sarcoma-associated herpesvirus RNA virus: Hepatitis C - HTLV Systemic DNA virus: Cytomegalovirus RNA virus: Mumps - Bornholm disease - Coxsackie B Retrieved from http://en..org/wiki/Wart Categories: Papillomavirus | Skin diseases | Viral diseases Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Asturianu БългарÑ?ки ÄŒesky Dansk Deutsch Ελληνικά Español Français í•œêµì–´ Ã?slenska Italiano עברית Latina Magyar Bahasa Melayu Nederlands 日本語 ‪Norsk bokmÃ¥l‬ Polski Português Runa Simi РуÑ?Ñ?кий Simple English Suomi Svenska Tiếng Việt УкраїнÑ?ька Walon ייִדיש ä¸æ–‡ This page was last modified on 29 August 2008, at 02:20
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