Warts are classified according to the site of involvement and the clinical appearance of the warts. There are more than 120 different genotypes of HPV viruses producing a variety of clinically distinct warts. HPV infections of the genitals caused by certain genotypes produce cancerous changes in both genders, especially in the female cervix at the entrance of the womb.
Types of Warts
There are different types of warts, depending upon the appearance and the site of involvement. All ages are affected, though warts are more common in the children and adolescents. Both sexes are affected equally. Warts grow uninhibited in persons with lowered immunity, as in HIV infection. Following are the common types of warts:
- Verrucae vulgaris. This is the common wart, presenting as firm, cauliflower-like growth. The number may vary from single to a few dozens. Though common warts can appear anywhere on the body, the back of the hands and fingers are the commonly affected sites.
- Filiform warts. As the name suggests, these are small finger-like projections, common on the face, neck and the scalp.
- Verruca plana or plane warts. These are small, brownish, pink or skin-colored, flat topped bumps with a smooth or slightly granular surface. Flat warts are usually seen on the forehead, chin, lower legs and forearms. The flat warts can get auto-inoculated after scratches or abrasions on the skin, the Koebner phenomenon.
- Plantar warts. On the soles of the feet, warts appear and grow inwards instead of outwards. Wart may be single or appear in groups, what are known as mosaic warts. These are usually found on the pressure points of the feet like the heels and the base of the toe bones. Plantar warts can be very painful and hence an aggressive strategy is required to get rid of the plantar warts.
- Palmar warts. Similar in appearance to the plantar warts, the Palmar warts may show a little more outwards extension than the plantar warts.
- Anogenital warts or Condyloma acuminata. These are fleshy, pink or grayish, single or multiple lesions, appearing on the genitals, and, at times, around the anal opening. Condyloma acuminata is a common sexually transmitted disease, though any intimate contact may cause transmission of the virus. At times condyloma acuminata can grow to enormous sizes, known as the giant condyloma acuminata of Buschke and Lowenstein.
- Epidermodysplasia verruciformis. These are generalized eruption of plain warts, which may develop cancerous changes later on.
How to Get Rid of Warts
Treatment of warts depends upon the following factors:
- type of wart, site of involvement
- number and extent of the lesions
- age and sex of the patients
Most of the warts are self-limiting and resolve simultaneously in a few months to years. Hence potentially scarring treatments are best avoided, especially in young children and on the face and the palms and soles. Certain medications like podophyllin are contraindicated in pregnancy. Painful plantar warts call for aggressive therapy for early removal.
There are many medical and surgical treatments available to get rid of the warts.
References:
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Sixth Ed, 2009
- Viral Infections, in IADVL Textbook of Dermatology, 3rd Ed, 2008
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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