Warts

Viral warts are benign papillomas caused by infection of the keratinocytes by human papilloma viruses (1).

• prevalence in the general population is estimated to be between 7-12% (2)
• commonly seen in childhood, but can occur at any age
  • small cohort observational studies have suggested that 5–30% of children and young adults have warts (1)

HPV is usually transmitted by direct skin-to-skin contact. Indirect transmission via contact with contaminated surfaces also may occur. Incubation period may last from 1 month to 2 years (3).

Risk factors include:

• immunosuppression
• close contact with affected people
• damaged epithelial barrier e.g. -
  • plantar warts transmitted from swimming pools due to the rough surfaces abrading the skin of the feet
  • nail biting - periungual warts
  • shaving – spreads warts over the beard area
  • along the sites of trauma – warts may develop in these sites, known as the Koebner phenomenon (2,3).

If the immune system is compromised they can present major problems to cure.

Reference:

• (1) Sterling JC et al. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol. 2014;171(4):696-712.
• (2) Lynch MD, Cliffe J, Morris-Jones R. Management of cutaneous viral warts. BMJ. 2014;348:g3339.
• (3) Primary Care Dermatology Society (PCDS). Clinical Guidance – Warts (November 2017)
• (4) HPA (2008) School health matters: a guide to communicable diseases and infection control. Health Protection Agency.