Other Factors ; Immunocompromise, such as occurs in HIV disease or after iatrogenic immunosuppression with solid organ transplantation, is associated with an increased incidence of and more widespread cutaneous warts. Occupational risk associated with meat handling.
Duration of Lesions ; Warts often persist for several years if not treated.
Verruca Vulgaris (Common Warts)
first begin as smooth, flesh colored papules,
lesion enlarge into dome-shaped, gray-brown irregular growths with rough hyperkeratotic clefted surface, with vegetations.
Characteristic " brown-black dots" are better seen with hand lens and are pathognomonic, representing thrombosed capillary loops.
The hands are the most common site but warts may be found on any skin surface.
Occur at sites of trauma
more often multiple than single
Pain is rare
Butcher's warts : large cauliflower-like lesions on hands of meat handlers.
Filiform warts have relatively small bases, extending out with elongated cap.
Simple occlusion with a relatively impermeable tape can be effective in eradicating warts.
Surgical destruction with cautery or ablation of warts can be effective treatment, but even complete destruction of a wart and the surrounding skin does not guarantee the wart will not recur. for warts that are refractory
Bleomycin has high efficacy and is an important treatment for recalcitrant common warts.