Plane warts

• flesh coloured or pigmented, well-defined, very slightly raised, flat-topped lesions
• the surface of a plane wart is smooth or very slightly roughened
• plane warts may occur anywhere but especially occur on the hands, limbs and face
• plane warts may be misdiagnosed, especially on the face, where they are liable to be treated with topical steroids, in which case they spread
• they may exhibit the Koebner phenomenon - occur in lines corresponding to scratch or other such trauma

Management:

• seek expert advice
• do not respond well to topical preparations
• in general, eventually disappear spontaneously and lesions on the limbs are often best ignored
• facial lesions may be treated with topical freezing techniques such as liquid nitrogen (used by an experienced practitioner for a short exposure). Salicylic acid (cream) and curettage and light cautery are other options (1)
• post-inflammatory pigmentation may occur in patients with pigmented skin and may take months to resolve

Reference:

• (1) Shankar S et al. Nongenital warts: recommended approaches to management. Prescriber 2007;18(4):33-44