SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (82)

Common wart in Adult
See also in: External and Internal Eye,Anogenital
Other Resources UpToDate PubMed

Common wart in Adult

See also in: External and Internal Eye,Anogenital
Contributors: Rajini Murthy MD, Susan Burgin MD
Other Resources UpToDate PubMed


Common warts (verruca vulgaris) are benign skin proliferations caused by infection of the epidermis with human papillomavirus (HPV), most frequently types 1, 2, and 4. Verruca vulgaris lesions may be acquired from direct contact with HPV-infected skin or, less commonly, from contact with HPV-carrying fomites. Autoinoculation is very common. Warts are frequent at locations that are traumatized. HPV types 2 and 4 may infect virtually any epidermal surface, including mucosal surfaces, but common warts are most often seen on the hands, feet, and knees. They may occur in tattoos.

Verruca manifest as skin-colored, hyperkeratotic papules. They may be pruritic, and scratching can produce a linear array of lesions via autoinoculation. Verruca vulgaris lesions are more prevalent in children and in immunocompromised patients; widespread, persistent lesions may be a clue to an underlying inherited or acquired immunodeficiency.

For unknown reasons, the incidence of common warts is approximately twice as high in White patients as in individuals of African descent and 10 times more common in Hispanic patients than individuals of African descent. In persons of African descent, the majority of warts are solitary, while most Hispanic patients present with multiple warts.

Immunocompromised patients often demonstrate larger confluent verruca that are more resistant to standard therapies. The presence of warts per se is not a reason for expensive immunological testing, however.


B07.8 – Other viral warts

57019003 – Verruca vulgaris

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Seborrheic keratosis – Has a characteristic "stuck-on," waxy appearance.
  • Clavus / Clavus – A painful hyperkeratotic lesion with a central core that lacks the pinpoint thrombosed capillaries and retains normal skin dermatoglyphics. Clavi occur in sites of pressure and repeated friction.
  • Foreign body granuloma – May have a history of trauma or inoculation.
  • Molluscum contagiosum – Lesions are smooth, dome-shaped papules with a central umbilication.
  • Actinic keratosis – Tends to be a scaly, erythematous papule on sun-exposed areas of elderly individuals.
  • Lichen planus – Lesions are typically more planar, violaceous, and pruritic.
  • Keratoacanthoma – Has a central keratin crater.
  • Cutaneous squamous cell carcinoma – Can arise in preexisting warts and may be recalcitrant to therapy.
  • Prurigo nodularis – Characterized by pruritic papules and nodules.
  • Perforating folliculitis – Tends to be follicularly based with a central core.
  • Cutaneous horn – Can arise from warts, hypertrophic actinic keratoses, seborrheic keratoses, and squamous cell carcinomas.
  • Lichen nitidus – Characterized by discrete, dome-shaped papules.

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required


Subscription Required

Last Reviewed:01/26/2021
Last Updated:01/26/2021
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Common wart in Adult
Print E-Mail Images (82)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Common wart in Adult
See also in: External and Internal Eye,Anogenital
A medical illustration showing key findings of Common wart : Fingers, Verrucous scaly papule, Feet, Knees, Dorsal hands
Clinical image of Common wart - imageId=885707. Click to open in gallery.  caption: 'A close-up of a verrucous plaque with overlying white scale and a similar smaller papule.'
A close-up of a verrucous plaque with overlying white scale and a similar smaller papule.
Copyright © 2024 VisualDx®. All rights reserved.