Extragenital cutaneous warts - clinical presentation, diagnosis and treatment.

Abstract

Extragenital cutaneous warts are benign epidermal tumors caused by human papillomaviruses (HPVs) and a frequent reason for patients to consult a dermatologist. Depending on wart type and site involved, the clinical presentation is highly varied. Given that warts represent a self-limiting condition, a wait-and-see approach may be justified. However, treatment is always indicated if the lesions become painful or give rise to psychological discomfort. Factors to be considered in this context include subjective disease burden, patient age, site affected, as well as the number and duration of lesions. Destructive treatment methods involve chemical or physical removal of diseased tissue. Nondestructive methods consist of antimitotic and antiviral agents aimed at inhibiting viral proliferation in keratinocytes. Some of the various immunotherapies available not only have localized but also systemic effects and are thus able to induce remission of warts located at any distance from the injection site. Especially patients with warts at multiple sites benefit from this form of treatment. Intralesional immunotherapy using the mumps-measles-rubella (MMR) vaccine is a particularly promising option for the treatment of recalcitrant warts in adult patients. For children, on the other hand, HPV vaccination is a novel and promising approach, even though it has not been approved for the treatment of cutaneous warts. At present, there is no universally effective treatment available. Moreover, many frequently employed therapies are currently not supported by conclusive clinical trials.

• Authors: Dietrich Abeck, Larissa Tetsch, Matthias Lüftl, Tilo Biedermann
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 17 Issue 6 Pg. 613-634 (Jun 2019) ISSN: 1610-0387 [Electronic] Germany
• PMID: 31241843 (Publication Type: Journal Article)
• Copyright: © 2019 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Chemical References

• Acetates
• Antiviral Agents
• Formates
• formic acid
• chloroacetic acid
• Salicylic Acid
• Fluorouracil

Topics

• Acetates (therapeutic use)
• Adult
• Antiviral Agents (therapeutic use)
• Cryotherapy (methods)
• Curettage (methods)
• Female
• Fluorouracil (therapeutic use)
• Formates (therapeutic use)
• Humans
• Laser Therapy (methods)
• Male
• Phototherapy (methods)
• Salicylic Acid (therapeutic use)
• Skin Diseases, Viral (pathology, therapy, transmission)
• Warts (pathology, therapy, transmission)
• Watchful Waiting