Vral warts

Common vral warts are caused by the human paplloma vrus types 1, 2 and 4 and can present on the fngers, hands and feet (Fgure 19.1). Plane (flat) warts may also occur on the dorsum of the hands and face. Typcally, warts have dark pnpont areas whch are thrombosed capllares more obvous when the wart s pared down (Fgure 19.1e). Ths sgn s essental to dfferentate a wart from an area of callus that could be mstakenly treated as a wart.

Warts are usually asymptomatc and treatment s not essental, partcularly n chldren. n chldren, the pan of lqud ntrogen cryotherapy s usually not tolerated. Warts around the nal folds (Fgure 19.2) or plantar warts can be treated wth salcyclc acd-based preparatons whch cannot be used on the face.

n adults presentng wth multple warts, mmunosuppresson should be consdered ncludng HV nfecton. Patents on longterm mmunosuppressves such as azathoprne and cclosporn can also be affected. Adults are lkely to tolerate more aggressve treatment such as cryotherapy or curettage.

Gental warts are treated usually n the gento-urnary department wth topcal mqumod or podophyllotoxn.

Hyperkeratotc warts are deally pared down to remove the thckenng pror to any treatments.

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