WARTS

DEFINITION

A wart (also known as a verruca when a plantar wart occurs on the sole of the feet
or on toes) is generally a small, rough tumor, typically on hands and feet but often other
locations, that can resemble a cauliflower or a solid blister. These warts are common,
and are caused by a viral infection, specifically by human papillomavirus 2 and 7. There
are as many as 10 varieties of warts with the most common being considered largely
harmless. It is possible to get warts from others; they are contagious. They typically
disappear after a few months but can last for years and can recur.
Types of Warts:

Verruca Vulgaris (the common wart)

These are thickened bumps called papules or plaques. They have a rough
surface and frequently will have small tiny spots which are from blood vessels
that have clotted. They are most commonly seen on the hands, elbows and
knees.

Flat Warts

se are flat-topped, smoother looking warts. They are brown or skin coloured.
They are most commonly seen on the face of women. They are spread easily by
shaving.

Plantar Warts
 se are seen on the under-surface of the feet. They are thickened. They can be
confused with corns or calluses. They will frequently have thrombosed blood
vessels causing black dots. They can sometimes be uncomfortable if they are in
weight-bearing areas. Occasionally they can be quite widespread involving large
surfaces. They tend to grow into the skin rather than coming outwards as most
other warts.

Genital Warts

se appear in the genital peri-anal skin. They have a variety of appearances. They
can look like common warts or sometimes they are skin coloured, small papules.
They vary in size from tiny papules to much larger typically warty growths.
Occasionally they are pigmented. There is a subgroup of these warts caused by
HPV 16 and 18 which have been named bowenoid papulosis. They have a small
chance of becoming cancerous. Some of the genital warts have been associated
with carcinoma of the cervix, Bowenoid papulosis and Bowen's disease.

SIGNS AND SYMPTOMS

Common warts are:

 Small, fleshy, grainy bumps

 Flesh-colored, white, pink or tan
 Rough to the touch

Common warts usually occur on your hands. They may occur singly or in multiples.
Warts may bleed if picked or cut and often contain one or more tiny black dots, which
are sometimes called wart "seeds" but are actually small, clotted blood vessels.
 DIAGNOSTIC PROCEDURES

 Skin biopsy

MEDICAL MANAGEMENT

 Laser therapy
 Liguid nitrogen
 Salicylic acid
 Plasters/electrodesiccation

 Freezing (cryotherapy, or liquid nitrogen therapy). Your doctor may use liquid
nitrogen to destroy your wart by freezing it. This treatment is usually only mildly
painful and is often effective, although you may need repeated treatments.
 Cantharidin. a substance extracted from the blister beetle — on your warts.
Typically, the extract is mixed with other chemicals, painted onto the skin and
covered with a bandage.
 Minor surgery. This involves cutting away the wart tissue or destroying it by
using an electric needle in a process called electrodessication and curettage.
 Laser surgery. Laser surgery can be expensive, and it may leave a scar. It's
usually reserved for tough-to-treat warts.
 Immunotherapy. This type of treatment attempts to harness your body's natural
rejection system to fight off warts. Topical immunotherapy medications that may
be prescribed for stubborn warts include squaric acid dibutylester and a gel
called imiquimod (Aldara). Imiquimod is marketed for the treatment of genital
warts but has also proved effective for treating common warts
 Bleomycin (Blenoxane). Your doctor may inject a wart with a medication called
bleomycin, which kills the virus. Bleomycin is used with caution for warts, but in
higher doses, is used to treat some kinds of cancer. Risks of this therapy include
nail loss and damage to the skin and nerves.
 Retinoids. Derived from vitamin A, these medications disrupt your wart's skin
cell growth.

NURSING MANAGEMENT

 Avoid touching warts on yourself or others.

 Do not share razors, towels, socks, or shoes with another person. Someone with
no visible warts can still be carrying the virus.
 Avoid walking barefoot on warm, moist surfaces where the wart virus may be
alive. Wear shower shoes when using public showers, locker rooms, or pool
areas.
 Keep your feet dry. If your feet sweat heavily, wear socks that absorb moisture or
wick it away from the skin.
 Avoid irritating the soles of your feet. Warts grow more easily if your skin has
been injured or broken in some way.

Tips on preventing warts from spreading

 Keep warts covered with a bandage or athletic tape.

 Do not bite your nails or cuticles, as this may spread warts from one finger to
another.