Hpv på engelska
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Myrmecial warts are typically tender with lateral and direct pressure, are surrounded by yellow hyperkeratotic callus-like skin showing accentuated skin markings, but with discontinuation of the skin lines through the actual wart.
Plantar epidermoid cysts are associated with HPV 60 infection of the eccrine ducts.
Plantar warts, myrmecial type (verruca plantaris)
Plantar warts
Plantar warts, mosaic type
Plane wart
Plane warts are typically multiple small flat-topped skin-coloured papules located most commonly on the face, hands, and shins.
Indications for active treatment include:
- Immunosuppression
- Presence of complications
- Patient preference.
Treatments do not kill the virus, but work by removing virus-containing skin. Plantar corns lack the papillary capillaries.
Dermoscopy assists visualisation of the papillary capillaries of a viral wart, and can distinguish other verrucous lesions such as a seborrhoeic keratosis.
Diagnosis of viral warts
Red and black pinpoint dots of papillary capillaries
Dermoscopy: viral wart
Dermoscopy: viral wart
Skin biopsy is sometimes required when squamous cellcarcinoma cannot be excluded clinically such as in an organ transplant recipient susceptible to both.
Other less common cancers include anal, vulvar, vaginal, mouth / throat and penile cancers.
Prevalence of HPV
HPV infections are very common. There are more than 150 known HPV types, only some of which infect the skin, giving rise to a variety of clinical presentations. They may be solitary or multiple.
They are also described as digitate (finger-like).
Filiform and digitate warts
Filiform wart
Butcher's wart
Butcher's warts are specifically caused by HPV 7 infecting the hands of butchers and others whose occupation involves chronic exposure to a cold moist environment.
Treatment with wart paint usually makes the wart smaller and less uncomfortable; 70% of warts resolve within twelve weeks of daily applications.
- Soften the wart by soaking in a bath or bowl of hot soapy water.
- Rub the wart surface with a piece of pumice stone or emery board.
- Apply wart paint or paste accurately and include a rim of normal skin.
- Allow the paint to dry before covering with plaster or duct tape.
- Next day remove the old paint and dead surface skin layer with a pumice stone and reapply the paint or paste.
If the wart paint makes the skin sore, stop treatment until the discomfort has settled, then recommence as above.
Cryotherapy
Cryotherapy with liquid nitrogen is repeated at one to two–week intervals to cause peeling of the surface layer.
These include cancer.
The most common type of cancer that HPV causes is cervical cancer. More than 80% of people, both women and men, will get HPV at some point in life.
Viral wart
What is a viral wart?
A viral wart is a very common benignlesion caused by infection with human papillomavirus (HPV).
Tiny red or black dots visible in the wart are papillary capillaries.
Common wart
Common warts (verruca vulgaris) present as cauliflower-like papules with a rough, papillomatous and hyperkeratotic surface ranging in size from 1 mm to 1 cm or more. Patent capillaries cause pinpoint bleeding. Persistence with the treatment and patience is essential!
Common warts are found most often on the knees, backs of fingers or toes, and around the nails (periungual).
Common warts (verruca vulgaris)
Verruca vulgaris on a thumb
Plantar wart
Plantar warts (verruca plantaris) include tender inwardly growing myrmecia on the sole caused by HPV 1, and clusters of superficial less painful mosaic warts due to HPV 2.
The wound heals in two weeks or longer (depending on the site); even then 20% of warts can be expected to recur within a few months. Recurrent wart in a scar is very hard to treat.
Other treatments
Other treatments for recurrent, resistant or extensive warts include:
How can viral warts be prevented?
Vaccines against human papillomavirus are available to prevent anogenital warts.
On the shins and beard-area of the face the virus is often spread by shaving resulting in numerous warts. Plane warts are mostly caused by HPV types 3 and 10.
Plane warts (verruca plana)
Verruca plana in the beard area spread by shaving
Filiform wart
A filiform wart is a cluster of fine fronds emerging from a narrow pedicle base usually found on the face.
Infection begins in the basal layer of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles — the wart. Anecdotally, these have been reported to result in the clearance of non-genital warts in some people without definite evidence that the vaccine is the cause of remission.
What is the outcome for cutaneous viral warts?
No treatment is universally effective at eradicating viral warts.
In children, even without treatment, 50% of warts disappear within six months, and 90% are gone in 2 years.
Viral warts are more persistent in adults, but they clear up eventually.
Viral warts can be classified by site as being cutaneous or mucosal as the HPV types are quite distinct [see Anogenital wart and Sexually acquired human papillomavirus for further information on mucosal HPV infection]. [see Verruca vulgaris pathology, Verruca plana pathology]
What is the differential diagnosis of a cutaneous viral wart?
Differential diagnoses for a cutaneous viral wart can include:
What is the treatment for viral warts?
Treatment may not be required in all cases as most warts resolve spontaneously especially in children.
Under local anaesthetic, the growth is pared away and the base burned.