Warts are bumps of skin and mucous membrane infections arising as a result of human papilloma virus (human papilloma virus, HPV). There are many types of this virus and some of them are potentially oncogenic. The possibility of malignancy relates to the changes induced primarily by the types 16 and 18, but also many others. Warts are common skin lesions. Infection occurs easily if there are any skin injuries, so changes often occur on the hands and feet. Particularly vulnerable are those who have impaired cellular immunity. Human papillomavirus can take the form of common warts, foot warts, juvenile warts or genital warts.
Wart normal (verruca vulgaris)
Clinical picture: Usually multiple hard lumps of skin with a rough, hyperkeratotic (the hands), sometimes villi (finger-like, thread-like, on the face) and the surface of the surrounding skin color or slightly darker, usually develops in children and young adults.
They are asymptomatic, have a tendency to spontaneous regression. About 40% of cutaneous warts disappear within two years without treatment. Location: common localization is hands especially the fingers, the location may be, however, optional. New eruptions occur in the vicinity of the primary tumor as a result of autoinfection.
Treatment: There are many equivalent methods to remove warts. They include the laser ablation vaporization (CO2), electrocautery, cryotherapy, curettage, topical application of 10% of salicylic acid or lactic acid, mono-, bi-, or trichloroacetic, 5-fluorouracil, bleomycin, and immunomodulating therapy (imiquimod). Attempts were made to be used vascular lasers, such as KTP.
Wart feet (plantares verruca)
The clinical picture: Warts may be in the form of a single wart, painful and deep or as multiple asymptomatic flat mosaic warts (mosaic warts), dealing with a substantial area of the foot. Infection occurs in swimming pools and other places where barefoot, especially common in children and adolescents. Under the influence of body weight changes penetrate deeply into the skin and cause pain when walking. Within the visible warts are sometimes small hemorrhages in the form of black spots.
Treatment: Similar to the treatment of common warts. In the case of mosaic warts major problem is their high recurrence rate.
Flat Warts (verruca plana)
Clinical picture: Small flat-lofty papules with a smooth surface, flesh-colored, often occur in children and adolescents, up to 4 mm in diameter. The changes are usually numerous and asymptomatic. Occur at any age, but most often in children and young adults. For predisposing factors include atopic dermatitis, minor skin injuries and immunosuppression. Warts after a longer or shorter time may resolve spontaneously.
Location: Flat warts are often found on the face, upper extremities, especially the hands.
Treatment: topically applied vitamin A derivatives, immunomodulators and preparations containing salicylic acid and 5-fluorouracil. Cryotherapy is also effective, however, involves a risk of discoloration and scarring after surgery.
Genital warts (condylomata acuminate)
Clinical picture: Changes in the shape of hypertrophic warts. The infection is transmitted mainly through sexual contact. The genital mucosa changes cauliflower creations take the shape of a narrow stalk. There is a correlation between certain types of HPV infection (16,18, 31, 33, 35) and the development of neoplastic lesions in the genital, especially the cervix. These changes are of a low risk of malignant transformation, but should raise suspicion rapid growth of warts, increased pigmentation, ulceration or property coexistence changes to the ground. Suspected precancerous condition (VIN) or cancer absolutely requires histopathological examination.
Location: Changes are placed on the genital mucosa. In women warts occupy labia and vaginal area, in men usually urethra. Changes can also develop around the anus pubis and groin.
Treatment: Imiquimod, podophyllin, surgical removal (laser, curettage, electroresection).
Clinical picture: Hard pearly papules to 0.5 cm with a central cavity from which the pressure escapes Cloddy content. Changes occur mainly in children and are the result of infection with molluscum contagiosum (molluscum contagiosum virus or MCV), belonging to the group of poxviruses. The pellets persist for several months, over time soften and disappear without leaving a scar. Molluscum contagiosum is a disease with a short, six-week incubation period, outgoing self-limiting and usually after 6-9 months.
Location: Changes are placed on the skin of the face and extremities, particularly the hands and in the genital area. Infection also transferred by sexual contact. Occasionally, changes may occur on the mucous membranes.
Treatment: Changes can be removed by cryotherapy, laser (CO2 laser) or curettage.