Viral warts are benign lesions caused by infection with human papilloma virus (HPV). They are classified as cutaneous or mucosal warts depending on their location. Cutaneous warts have a hard keratinous surface that may be yellow or brown, with tiny red or black dots visible that are papillary capillaries. Viral warts are infectious and can cause complications like nail dystrophy from periungal warts or pain interfering with activities from plantar warts. Diagnosis involves examining the red or black dots that appear when a wart is pared down and cause pinpoint bleeding. Treatment options include electrosurgery, which leaves scarring, or topical treatments with salicylic acid

1. VIRAL WARTS
By: D. Gangadhar
4th sem

2. What is a viral wart?
• It’s a common benign lesion caused by
infection with Human Papilloma Virus (HPV)
• They are classified by site as being cutaneous
or mucosal

3. Clinical features of viral warts
• Cutaneous viral warts have hard keratinous
surface
• They may be yellow or brown
• Tiny red or black dots visible in wart are
Papillary capillaries

4. Complications of cutaneous viral warts
• Viral warts are infectious to patient and others
• Periungal warts can cause nail dystrophy and
destruction
• Pain due to plantar warts interferes with
walking and sporting activities
• In epidermodysplasia verruciformis the
specific HPV types can cause squamous cell
carcinoma

5. Diagnosis
• Pinpoint red or black dots are revealed when
wart is pared down.
• Patent capillaries cause pinpoint bleeding
• Tenderness is maximal with lateral pressure
for a plantar wart, whereas a corn or callus is
more tender with direct pressure
• Skin biopsy is sometimes required to rule out
squamous cell carcinoma

6. Differential diagnosis
Differential diagnosis for cutaneous viral wart
can include:
• Seborrhoeic keratosis
• Squamous cell carcinoma
• Plantar corn and callus

7. Treatment | Electrosurgery
• Electrosurgery (curettage and cautery) has
been used for large and resistant warts
• Under local anaesthetic the growth is pared
away and the base is burned
• The wound heals in 2 weeks or longer.
• This treatment leaves a permanent scar which
can be painful to walk if located on pressure
site
• Recurrent wart in a scar is hard to treat

8. Treatment | Topical
• Topical treatment includes pastes or patches
containing salicylic acid, podophyllin, or
similar compounds which work by removing
the surface skin cells
• Applied once daily to the wart. 70% of warts
resolve within 12 weeks of daily applications

9. Outcome of Viral warts
• No treatment is universally effective at
eradicating viral warts
• In children even without treatment, 50%
disappear within 6 months and 90% in 2 years
• They are likely to recur in immunosuppressed
patients and tobacco smokers
• Vaccines against HPV are able to prevent
anogenital warts

10. Thank you