Warts are a common viral infection of the skin caused by the human papillomavirus (HPV). There are more than 100 subtypes of HPV.
Warts occur most commonly in children and young adults. It can, however, occur at any age.
Common warts most commonly occur on the hands and around the nails. They may occur as single or multiple lesions, and appear as flesh-coloured nodules with a rough surface and small pit-point blood vessels. They may bleed if the surface is scratched or pared.
Flat warts occur commonly on the face, neck, arms, and legs. They are usually seen as smooth, flesh-coloured, pink or brown, flat-topped papules.
Plantar warts occur on the soles of the feet and toes and may be painful on pressure (eg. walking). It may be difficult to differentiate from corns (calluses).
Ano-genital warts occur around the genitals and are uncommon in children. Although most often transmitted sexually in adults, this is rarely the case in children, when it can occur through non sexual contact.
Warts may be transmitted between individuals by skin-to-skin contact or from the environment (eg. swimming pool decks, change room floors). They can spread from one area of the body to another within the same patient. It may take one to six months for warts to appear after initial infection.
Laboratory tests of HPV infection are usually unnecessary as the diagnosis is usually clinical.
Watchful waiting: In children, warts may resolve spontaneously. However, this may take up to two years to occur.
Even when the wart appears “cured”, there is a 20% risk of recurrence, either at the same or other site(s).
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