VERRUCAE (Warts)

Causative agent is Human Papilloma Virus (HPV).

1. Verruca Vulgaris

This mainly involves hands. Elementary lesion is papule. Surface of this papule is hyperkeratotic and papillamatous. Papules are generally multiple. Diameters of these papules are under 0.5 cm. Satellite lesions in the periphery occur by trauma (Köbner phenomenon). The patients have not subjective symptoms, but may have pain after trauma if they have warts around and/or under the nails.

2. Verruca Plantaris

This is a kind of verruca vulgaris that involves plantar area. Papules are flat because of pressure. These mainly occur on traumatic areas and pressure leads to pain. Differential diagnosis must be made with cores. Papillamatosis is a feature of verrucae and trauma leads to punctate hemorrhages at the top of the papillae, so one can see black dots in the verrucous area.

3. Verruca Planus

The color of the papule is generally dark or brown. Multiple papules are in several millimeters of diameter, slightly elevated and plain. They are mainly localized on the hands and face. They are difficultly distinguished if they are in flesh color, but the patient attends to a dermatologist for dark spots if they are brown.

4. Verruca Filiformis

Warts with a long thread-like stalk and finger-shaped excrescences are called as verruca filiformis. These types occur on beard, scalp and/or around nostrils. Shaving supports the spreading (Köbner phenomenon).

5. Verruca Anogenitalis (Condyloma accuminata)

They are in flesh color or brown. Flat papules or vegetating masses may be seen. In the perianal region warts are compressed laterally and are often cockscomb-like. Some of them tend to malignancy.

Treatment

Warts may spontaneously heal. Dermatologist may wait for a while if the patient have a few papules and have not any complaint. Treatment is necessary for the patients have pain or spreading lesions. Electro-coagulation, cryotherapy, acid applications and lastly surgical interventions may be thought.