wart

wart, circumscribed outgrowth of the skin caused by a filterable virus that is readily transmitted. Warts may appear anywhere on the skin but are most common on the hands. Sexually transmitted diseases and human papillomavirus produce warts in the genital area; these are often precancerous growths. Some warts disappear spontaneously; others persist for many years. However, there is also a tendency to develop new lesions. Warts are treated by surgical excision (sometimes by electrocautery), bloodless removal by freezing with liquid nitrogen, or repeated applications of ointments or creams. Those on the soles of the feet (plantar warts) are the most painful and most difficult to treat, since on pressure-bearing areas they may become depressed beneath the surface of the skin.

or verruca

Well-defined growth on the skin, usually caused by a papillomavirus, which triggers overproduction of epidermal cells. This may lead to a single long-standing wart, profuse local spread (especially in moist areas), or warts in various parts of the body. The most common type is a round bump with a dry, rough surface. Warts are usually painless except in pressure areas, such as the sole of the foot (plantar wart). Genital warts are merely a nuisance unless they become large or numerous enough to interfere with urination, defecation, or childbirth, but some viral strains are associated with cervical cancer. Warts are considered contagious. They may be removed by applying acids, cryotherapy, electrocautery, or surgery; they sometimes disappear spontaneously.

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(born Dec. 29, 1809, Liverpool, Eng.—died May 19, 1898, Hawarden, Flintshire, Wales) British politician and prime minister (1868–74, 1880–85, 1886, 1892–94). He entered Parliament in 1833 as a Tory, but after holding various government posts, including chancellor of the Exchequer (1852–55, 1859–66), he slowly converted to liberalism and became Liberal Party leader in 1866. In his first term as prime minister (1868–74), he oversaw national education reform, voting reform (see Ballot Act), and the disestablishment of the Irish Protestant church (1869). In 1875–76 he denounced the indifference of Benjamin Disraeli's government to the Bulgarian Horrors. In his second term, he secured passage of the Reform Bill of 1884. His cabinet authorized the occupation of Egypt (1882), but his failure to rescue Gen. Charles George Gordon in Khartoum (1885) cost Gladstone much popularity and his government's defeat. In 1886, throwing his weight behind support for Irish Home Rule, he was able to regain control of Parliament, but when his Home Rule Bill was rejected he resigned. He devoted the next six years to trying to convince the electorate to grant Home Rule to Ireland. Liberals won a majority again in 1892, and in his fourth cabinet he piloted through another Home Rule Bill, but it was soundly rejected by the House of Lords. He was buried in Westminster Abbey.

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A wart (also known as verruca) is generally a small, rough tumor, typically on hands and feet but often other locations, that can resemble a cauliflower or a solid blister. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV) and are contagious when in contact with the skin of an infected person. It is also possible to get warts from using towels or other objects. They typically disappear after a few months but can last for years and can recur.

Types of wart

A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved. These include

• common wart (Verruca vulgaris), a raised wart with roughened surface, most common on hands and knees;
• flat wart (Verruca plana), a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees;
• filiform or digitate wart, a thread- or finger-like wart, most common on the face, especially near the eyelids and lips;
• plantar wart (verruca, Verruca pedis), a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet;
• mosaic wart, a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet;
• genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata), a wart that occurs on the genitalia.

Treatment

Prescription

Treatments that may be prescribed by a medical professional include

• Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers ("immunomodulators"), or formaldehyde, often with mechanical paring of the wart with a pumice stone, blade etc.;
• Cryosurgery, which involves freezing the wart (generally with liquid nitrogen), creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin falls off by itself;
• Surgical curettage of the wart;
• Laser treatment;
• Imiquimod, a topical cream that helps the body's immune system fight the wart virus by encouraging interferon production;
• Injection of Candida, mumps, or Trichophyton antigens at the site of the wart, which stimulate the body's immune system;
• Cantharidin, a chemical found naturally in many members of the beetle family Meloidae which causes dermal blistering.

The wart often regrows after the skin has healed.

One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75% observed with salicylic acid compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants. The reviewers also concluded that there was little evidence of a significant benefit of Cryotherapy over placebo or no treatment.

Over-the-counter

There are several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid or a bottle of concentrated salicylic acid solution. Removing a wart with salicylic acid requires a strict regimen of cleaning the area, applying the acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a wart.

Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing.

Duct tape occlusion therapy

Duct tape occlusion therapy (DTOT) involves placing a piece of duct tape over the wart(s) for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. Evidence suggests that DTOT is more effective than cryotherapy,

The study cited above had 9 patients lost to the follow-up from the original 61 patients entered. In contrast to the flaws (15% of subjects lost to the follow-up) and favorable results of the above study, a more stringent study of 103 children found no benefits from duct tape . The evaluators were blinded during treatment for the most part, a placebo (corn pad) was used and there were no patients lost to the follow-up. After six weeks, rates of wart resolution were similar in the duct tape and corn pad groups and much lower than the rates seen in the earlier trial. A similar trial comparing duct tape with a control treatment with a moleskin pad in 90 adults also found no difference in the rate of wart resolution at the end of two months (21 versus 22 percent) .

See also

• Laryngeal papillomatosis
• Molluscum contagiosum
• Epidermodysplasia verruciformis

References

External links

• Wart photo library, Dermnet