What is a wart? We will analyze the causes of occurrence, diagnosis and methods of treatment in an article by a dermatologist with 37 years of experience.
Definition of disease. Causes of disease
Wartsare benign, light-bodied, irregular skin lesions in the form of localized overgrowth of the top layer of skin (epidermis) with papules (nodules) or plaques.
The incidence of warts in adults is 7-12%, in children of school age - up to 10-20%.
warts very similar to other cutaneous growths. Usually, a person cannot accurately identify a disease on his own, so a dermatologist should be consulted for a diagnosis.
Human papillomavirus is the cause of warts. The type of virus affects the type of warts that can develop. Thus, each type of HPV infects tissues in the site that characterizes it the most.
| HPV Type | Favorite translation Translation |
Types of Warts |
|---|---|---|
| 1 | feet, knees, palms hands and fingers |
plantar and palmar warts, simple warts |
| 2, 4 | hands, fingers, and knees much lower - feet |
simple warts sometimes plantar and palm and mosaic warts |
| 3, 10 | legs, hands, face | Flat Warts |
| 7 | Hands and Fingers | Butcher's Warts |
| 5, 8, 9, 12, 14, 15, 17, 19-24 |
Face and Arms, Front Trunk |
verruciform epidermodermodysplasia |
virus infection usually occurs through contact - with direct contact between infected skin and healthy skin (for example, when shaking hands) or indirectly (through handrails, toys, etc. ). Therefore, it is possible to get infected with the human papillomavirus, which causes warts, in various places - on public transport, at school, at work, at home, in places with high contact and humid environment (swimming pools, saunas, gyms). . Small trauma to the epidermis, through which viruses enter, as well as dermatitis, contribute to infection.
also contributes to the appearance of warts:
- Immunodeficiency (including HIV infection);
- A warm, humid environment;
- The need for professional contact with meat and fish ("butcher's warts").
Some types of HPV are transmitted from parents.
But frogs and frogs, despite the horror stories that we fear so much in childhood, cannot become infected - this is one of the most common myths about this disease, which has no basis.
If you experience similar symptoms, see your doctor. Do not self-medicate - it is dangerous for your health!
wart symptoms
Symptoms will vary depending on the type of wart.
Common wart:
- Dense, round papule of normal color, 1-10 mm and larger.
- The surface of the papule is covered with cracks and layers.
- If the papule is on the finger, the imprint is hidden and deformed. The same goes for drawing palms. Simple warts are found either singly or in several pieces - they usually appear in the most affected places (hands, fingers, knees).
- When viewed with a dermatoscope, the doctor may see small brown spots - clotted capillaries (blocked). Often patients refer to these points as "roots. "This is the doctor's main sign: a dermatologist can use it to distinguish a wart from other similar diseases (for example, molluscum contagiosum and keratoma).
Warty plantar (horny):
- The main symptom that usually prompts a patient to see a doctor is pain when pressing and walking. Usually these warts are localized on the feet.
- When contacting the doctor, as a rule, an uneven keratinized plaque of the usual color appears, although at the first stage you can see an even, smooth papule. With keratosis, capillaries can only be seen if the keratinized layer of the skin is removed.
- Sole leather deformed. Plantar warts are usually single, but there are also 2-6 warts; These warts are often confused with corns (especially dry ones) - this is a description of the problem that patients usually see.
Flat Wart (Juveniles):
- looks like a round, translucent, smooth papule of regular color, pink or brown, size 1-5 mm.
- appears on the hands and legs, often on the face There are always several of these warts - they are found in clusters.
verruciform epidermodysplasia (aging wart):
- Large, round, numerous tumors clustered of normal, pink, or brown color.
- They often appear on the face, arms, and front of the torso.
- can be confused with keratoma, shingles, and melanoma.
causing wart
When entering the body, HPV can be in a latent state for a long time - a person usually does not know its presence. When favorable factors for the virus appear, it begins to "multiply" in the epithelium, which leads to tissue changes.
Unlike other viruses, HPV does not destroy the epithelial cells themselves - they die on their own, naturally, in the process of keratinization and desquamation.
Local factors and immune system status influence the spread of infection. For example, people with HIV infection or a kidney transplant are more likely to have warts. Moreover, these tumors are often difficult to treat. With normal immunity, the virus does not affect the deeper layers of the skin, so many people will catch warts on their own after a few months.
The main stage in the emergence of warts is to accelerate the rate of cell division and growth with the help of the virus. This rapid metabolism thickens the layers of the skin. As the tissue grows in a certain small area, a tubercle called a wart appears.
classification and stages of wart development
There is no generally accepted classification for warts. However, there are several common types:
- common wartis the most common type (only 70% of warts are). These neoplasms are not felt and cause only aesthetic discomfort to the person.
- Verruca- appears on the soles of the feet, and is painful, so requires treatment. Skin trauma due to uncomfortable, tight and angry shoes contributes to the development of such a wart.
- Flat Warts- They often appear in young adults and teens. This is due to the unstable hormonal background in youth, which affects the whole body. Flat warts are usually almost invisible
- senile warts- typical for the elderly. It most often appears on the covered part of the body, but can appear on the face and hands. If there is no discomfort, then these warts should not be treated - the healing in the elderly can be much slower than in the young, due to their slow metabolism.
Other authors distinguish several other types of these types of warts:
- Mosaic warts(HPV 2, 4) - tumors on the palms and soles. They look like foci of hyperkeratosis, that is, a thickening of the stratum corneum (usually on the front of the foot), covered with deep fissures.
- cystic warts(HPV 60) are a very rare type of bunion found on the foot. It is a smooth knot with slits. On opening, a white-yellow curd-like secretion appears.
- Filiform wartsare thin, corneal bumps near the mouth, nose, or eyes.
- "butcher's warts"(HPV 7) - appear on the hands and fingers of people who are in constant contact with meat and fish. They appear as enlarged tumors similar to cauliflower, but of normal color.
In addition, the types of warts are distinguished depending on their location.
Therefore, genital warts - tumor-like tumors that appear on the genitals (especially in places where the skin has moved to the mucous membrane) is a common disease. It is usually caused by HPV types 6 and 11.
multiples of wart
The main reason why patients with warts go to the doctor is an aesthetic defect that can affect the patient's quality of life, self-confidence and develop a lot of complexes. Complications can also include cracking of the surface of the wart and adding infection, and in some types of warts, soreness while walking.
Skin warts usually do not turn into malignant tumors, they are completely harmless, however, in very rare cases, such complications can still occur in people with weakened immune systems.
Other complications arise when trying to remove tumors on their own. In this regard, infections and aesthetic defects in the form of scars may occur, as well as an increased spread of the virus through the skin, which may lead, in the morning after the self-removal of one wart, to the person waking up with several new warts.Remember that under the guise of a wart, a completely different disease can be hidden, and it cannot be identified without consulting an experienced doctor.
Diagnosing a wart
Examination (clinical picture) and medical history are usually sufficient to make the diagnosis.
To confirm the diagnosis, the doctor can perform a histological examination - studying the tumor cells.
It is very important to carry out a differential diagnosis - to distinguish warts from other diseases. For example, common wartsshould be distinguished from the following diseases:
- Molluscum contagiosum- It appears most often on the body and genitals, most often on the hands and feet. It is hemispherical with an impression on the surface; When pressed from both sides, a white "gruel" is released.
- a warty nevus- often solitary, and he's born from birth. It rises above the surface of the skin, and is often covered with hair.
- Basalioma- a tumor shaped like a roll of nodule covered with a crust in the center. Typical for the elderly.
palm plantar wartsshould be distinguished from the following diseases:
- Keratoderma- large areas of keratosis and dermatitis. No capillaries clot.
- Plantar syphilis- multiple painless, crusting lesions of the skin along the periphery. Syphilis has a positive reaction
- Corn- usually painless, it may only cause pain when pressed vertically.
The doctor must also differentiate between other types of warts and a number of diseases. If another disease is suspected, he may prescribe additional diagnoses (for example, antiviral detection, computed tomography or magnetic resonance imaging).
Treating warts
Warts are treated for aesthetic purposes and to improve the patient's quality of life. It can only be prescribed by a doctor after an accurate examination and diagnosis. Independent attempts to get rid of the wart are unacceptable, because a patient without medical education and the necessary equipment is unable to accurately identify the disease, and complications after this "treatment" occur much more than cure.
There are several methods of treating warts. They are all usually performed under the supervision of a physician, and some - only in the clinic's treatment room.
Chemical Treatment
Collodion salicylic and milk patches are used to get rid of the wart. The percentage of drugs and the method of their use (long-term wearing of plasters, applications, etc. ) depends on the spread and localization of the tumor.solutions of zinc and 2-chloropropionic acid may also be used. In this case, a chemical formula is applied to the pre-treated surface, which is left on the wart until it changes color (depending on the type of wart). The procedure is repeated several times after 7, 14 and 21 days. Before each procedure, the tissue is removed mechanically.
Another chemical method is a combination of nitric, acetic, oxalic, lactic acids and copper nitrate trihydrate. In this way, relatively small tumors are treated - up to 5 mm. The solution is also left to change the color of the wart. After 3-5 days, the patient comes for a follow-up appointment, if necessary, is prescribed a second procedure within 1-4 weeks.
Cold Destruction
This method consists of freezing the wart with liquid nitrogen: The wet plug is pressed against the damaged skin (picking up the surrounding tissue by a few mm) for 1-5 minutes. Some lesions require multiple treatments four weeks apart to be destroyed
The main disadvantages of cryodestruction are pain and delayed effect compared to other methods, where only one procedure is sufficient for removal.
Electrocoagulation
Under the influence of an electric current, the wart is removed in layers. This operation is performed under local anesthetic
This method is more effective than cryotherapy, but it has one major drawback: electrocoagulation often leaves scars at the site of removal of the wart. For those patients who seek to correct a cosmetic defect,
this method will not be the most appropriate.
Laser Destruction
The laser also removes warts in layers. The light wave comes into contact with the skin for several seconds to three minutes, depending on the size. Then the scabs that appear is removed, and the bottom of the wound is laser treated again. Then the patient is instructed on how to handle the wound. The operation itself is performed under local anesthesia.
Radiofrequency Surgery
Radiofrequency surgery is one of the most modern and gentle methods of removing some benign tumors, including warts.
The method is based on the generation of electromagnetic waves of different frequencies: from 100 kHz to 105 MHz. During the process, the tissues resist the transient waves, and for this, molecular energy is released into the cells, which causes the skin to heat up. Under the influence of heat, the cells actually evaporate - a neat cut is obtained. At the same time, there are no mechanical forces on the affected tissues.
Advantages of this method:- Security;
- Rapid wound healing;
- Good cosmetic effect - scars and scars are excluded;
- Relative pain - a local anesthetic is applied before the mini-surgery;
- Eliminating secondary infection due to automatic electrode disinfection when operating the device.
The effectiveness of this method is recognized worldwide, however, it is difficult to find a clinic using the radiowave surgery method.
Which treatment method should be chosen
All of the above methods have several drawbacks:
- In the first two weeks, the surgical area looks unattractive - scales, darkening of the tissues. This should be taken into account if the warts are on visible parts of the body (for example, on the face).
- Bad smell and some degree of pain during surgery.
In addition, each of these methods has contraindications, which you need to know in a preliminary consultation with a dermatologist.
but the main defect isThere is a high probability of relapse of, especially if the warts are widespread and extensive. With each of these methods, doctors do not fight the root cause of the disease, but with its consequences, since todayHPV cannot be cured.
Therefore, the treatment is directed to:- or destroying tumors that appear at the site of entry of the virus;
- Either to stimulate the antiviral immune response;
- or a combination of these.
The most destructive treatment methods are used. Its efficiency reaches 50-80%.
Childhood is not usually a contraindication to surgical treatment. Therefore, many of them (including radiofrequency surgery) are also used to treat warts in children. The exception is the chemical removal of warts due to the possibility of negative reactions to the substance.
What to do after operation
After any of these operations, be sure to follow your doctor's recommendations.
After removing the tumor with any of the presented methods, the doctor usually prescribes treatment for the removal site. Do not remove the "scales" yourself, moisten the wound and expose it to direct sunlight.
If a patient constantly suffers from warts, he should consult an immunologist - drug therapy may be required, which increases immunity resistance to the manifestations of HPV.
expectations. Prevention
If the patient is not immunocompromised, the warts can disappear on their own, but this will take a long time - from several months to several years. Therefore, in 65% of cases, warts regress independently within two years. If the wart is still in place after two years, it is recommended to remove it. It is recommended to remove multiple extensions immediately.
With natural immunity and a properly selected method of removal (depending on the size and type of wart), it is possible to remove pathogenic tissues and achieve a good cosmetic effect. With reduced immunity and other predisposing factors, residual HPV in the body causes relapses.
There is no specific prevention. But is infection inevitable?
You can reduce the possibility of contracting a virus if you follow some rules:
- Avoid walking barefoot in public places where there is a possibility of skin infection and virus infection (swimming pools, public showers, gyms). Choose high-quality shoes, and change them often. Try to keep your feet dry. Heat and moisture are fertile breeding grounds for HPV.
- To avoid warts surrounding the fuzz, only go to a certified nail technician and be sure to use sterile tools.
For preventing genital warts, according to the World Health Organization (WHO), a quadrivalent vaccine against HPV is also very effective. There are currently no vaccines available to prevent other types of warts.
If you find a single wart, do not try to cauterize, cut, or pick it yourself - this way you can contribute to inflammation and further spread the virus through the skin. After this "removal", instead of one wart in the morning, you can wake up with ten.