Warts

Question 1

What are warts?

Answer 1

Warts are different morphological variants of skin lesions caused by the human papilloma virus (HPV).

Question 2

What is the causative agent of warts?

Answer 2

The human papilloma virus (HPV).

Question 3

How do different HPV types affect the presentation of warts?

Answer 3

Different HPV types are associated with specific clinical patterns and varying oncogenic potential.

Question 4

Which age group is most commonly affected by warts?

Answer 4

Children are most commonly affected.

Question 5

How are warts transmitted?

Answer 5

By direct contact and inoculation of the virus into the skin

Question 6

What virus causes all types of warts?

Answer 6

Human papilloma virus (HPV).

Question 7

What do plane warts look like?

Answer 7

They have a smooth surface and are slightly elevated (planar) above the surrounding skin

Question 8

What is the colour of plane warts?

Answer 8

They may be hypo- or hyperpigmented.

Question 9

In which patients are plane warts more extensive?

Answer 9

In individuals with HIV.

Question 10

Which HPV type causes plane warts?

Answer 10

HPV type 3.

Question 11

What do common warts look like (verruca vulgaris)

Answer 11

Flesh-coloured, hyperkeratotic nodules, plaques, or tumours.

Question 12

Where are common warts (verruca vulgaris) most often found?

Answer 12

On the fingers, hands, arms, and face. Oral mucosal lesions may also occur.

Question 13

What is seen when a common wart is pared with a blade?

Answer 13

Punctate black haemorrhagic dots.

Question 14

What are the possible appearances of genital warts?

Answer 14

They may be flat, dome-shaped, cauliflower-shaped, or pedunculated.

Question 15

Where do plantar warts occur?

Answer 15

On the sole of the foot.

Question 16

How do plantar warts appear?

Answer 16

As papules or plaques with loss of skin markings and overlying hyperkeratosis.

Question 17

How can plantar warts be differentiated from callouses?

Answer 17

Plantar warts are tender on side-to-side pressure and show black haemorrhagic dots when pared; callouses do not

Question 18

How do plane warts (verruca plana) typically respond to treatment?

Answer 18

They generally have a poor response to treatment.

Question 19

What topical agents can be tried for plane warts (Verruca Plana)?

Answer 19

Tretinoin cream or salicylic acid.

Question 20

When are systemic retinoids indicated for plane warts?

Answer 20

In cases of extensive or disfiguring disease.

Question 21

What is the initial management approach for common warts (Verruca Vulgaris)?

Answer 21

Watchful waiting, as most will resolve spontaneously.

Question 22

What home-based regimen can help remove common warts?

Answer 22

Soak in hot water, pare with sandpaper, pumice stone, or blade, then apply daily wart paint containing 20% salicylic acid, 20% lactic acid, and 60% collodion.

Question 23

What are some procedural treatment options for common warts?

Answer 23

Liquid nitrogen (cryotherapy), cautery, or cantharidin application.

Question 24

What is the first-line topical treatment applied by a healthcare worker for genital warts?

Answer 24

Podophyllin tincture 25%, applied once or twice weekly until the warts clear

Question 25

How should podophyllin be applied safely?

Answer 25

Protect surrounding skin with petroleum jelly, leave warts exposed, apply a thin layer of podophyllin, then sprinkle talc powder to cake the mixture and prevent spreading to normal skin. Wash off after 4 hours

Question 26

Who should apply podophyllin?

Answer 26

A healthcare worker.

Question 27

What patient-applied treatment can be used for genital warts?

Answer 27

Podophyllotoxin 0.5%, applied twice daily for 3–4 days, followed by a 3-day rest. The cycle is repeated until warts clear.

Question 28

What are some procedural options for genital wart removal?

Answer 28

Cryotherapy or cautery.

Question 29

What safety precaution should be taken during cautery of genital warts?

Answer 29

Wear a mask to avoid inhaling fumes that may contain viable wart particles.

Question 30

What immune-modulating cream can be used for genital warts?

Answer 30

Imiquimod, applied thinly three times a week for 16 weeks.

Question 31

What initial steps are recommended before applying wart paint to plantar warts?

Answer 31

Soak the foot in hot water and pare the wart with a blade, pumice stone, or sandpaper.

Question 32

How should wart paint be applied for plantar warts?

Answer 32

Protect surrounding skin with petroleum jelly, apply wart paint (20% salicylic acid, 20% lactic acid, 60% collodion) to the wart, then occlude with a plaster. Repeat daily

Question 33

What additional agent can be used for plantar wart treatment?

Answer 33

Cantharidin