Warts are superfluous lesions on the skin surface caused by human papilloma virus. The incubation period is 1 to 3 months and can spread by self-inoculation. The virus is present in the spiny layer of cells and can cause the cells to proliferate and form warts. According to the clinical manifestations and locations, they are classified as common warts, flat warts, plantar warts, genital warts (condyloma acuminata), oral warts, pharyngeal warts, and warty epidermal dysplasia.
Etiology
Warts are caused by human papilloma virus infection. They can be transmitted through direct or indirect contact. Perianal and genital warts are mostly transmitted through sexual contact. Trauma or skin breakdown is an important factor in HPV infection. The course of warts has an important relationship with the body’s immunity. The incidence of warts is increased in people with immunodeficiency states, such as kidney transplants, malignant lymphoma, chronic lymphocytic leukemia and lupus erythematosus patients. However, the mechanism by which warts persist in relatively healthy populations is not known.
Clinical manifestations
1, common warts
The Chinese medicine called “a thousand day sores”, commonly known as “wart”, “wart” and so on. The first thing you need to do is to get a large needle point papule, gradually increase to pea size or larger, round or polygonal, the surface is rough and prickly, hard, grayish yellow, dirty yellow or dirty brown, continue to develop a papillary proliferation. It is easy to bleed when rubbing or impacting. The initial occurrence is often one, which remains unchanged for a long time or keeps increasing, and the neighboring ones fuse with each other, and sometimes can inoculate themselves.
They are usually uncommon in adolescents and have no conscious symptoms, and occasionally have pressure pain. The common warts can occur on any part of the body, most often on the fingers, back of the hand, and the edge of the foot. The process is chronic, and about 65% of common warts will subside in 2 years.
Special types of warts include: (1) filiform warts, which occur on the eyelids, neck, and chin, are single, soft, filiform projections. The skin is normal or brownish-gray in color. There are usually no conscious symptoms. The first of these is a cluster of uneven finger-like protrusions on the same soft base, with a keratin-like tip. The number varies, often occurring in the scalp, can also occur between the toes, face. The actual fact is that there are no conscious symptoms.
2, plantar warts
The first is a small shiny papule, and then gradually increase, the surface keratinization, rough uneven, gray-brown, gray-yellow or dirty gray, round, clear boundaries, surrounded by a slightly higher thickening of the keratin ring. The rash is usually found on the heel, metatarsal head or interdigital pressure. It is painful to varying degrees and has a chronic course that may subside spontaneously. It is generally believed to be more likely to subside in children than in adults, but it is less likely to subside in those with sweating or metatarsal abnormalities.
3, flat warts
Generally no conscious symptoms, occasionally slightly itchy. They occur on the face, back of the hands and forearms. The course of chronic, sometimes suddenly disappear on their own, or continue for many years, after healing does not leave a scar.
4, perianal genital warts (condyloma acuminatum).
Differential diagnosis
The clinical performance of the various warts, the site, the development of the diagnosis is not difficult. Differential diagnosis.
1, common warts and warty skin nodules
The latter are irregular wart-like plaques surrounded by a red halo. The latter is an irregular wart-like plaque surrounded by redness. A positive tuberculosis-related test helps to differentiate.
2, plantar warts and corns to distinguish
The core of the corpuscles is translucent and yellowish-white, with obvious pressure pain and a smooth surface.
3, flat warts and sweat tuberculosis to distinguish
The latter is good near the eyelids, generally close to the skin color, histology is completely different.
4, plantar warts and punctate palmoplantar keratosis to distinguish
The latter has an early onset, often with a family history, palms, feet and plantar damage, scattered distribution, in order to pressure areas obvious.
Treatment
Most warts patients in the onset of 1 to 2 years to subside on their own, many patients even if the depth of destructive methods, there are 1/3 warts still recur, so you need to choose carefully, some can cause permanent scarring therapy, should not be used.
1, drug treatment
(1) fluorouracil ointment.
(2) Bleomycin intra-lesional injection.
(3) 0.7% of spotted viperine
(4) 0.1% to 0.3% alcoholic solution of retinoic acid
(5) 3% phthalimide ointment or 3% phthalimide dimethyl sulfoxide application.
(6) 0.5% ghost moth toxin
(7) 5% Imiquimod cream.
(8) Antivirals.
(9) Others, salicylic acid, procaine, etc. have been reported. Interferon, transfer factor, thymidine and other immune enhancers, systemic or wart injection.
2, photodynamic therapy
Systemic or local topical photosensitizers, light after causing local cell death, can treat some common warts, condyloma acuminata.
3, physical therapy
4, surgical excision
The actual surgical excision of individual huge warts is feasible.