Common wart in Child
See also in: External and Internal Eye,AnogenitalAlerts and Notices
Synopsis
Verruca vulgaris lesions are more prevalent in children aged 4-12 years. The HPV virus is often passed between siblings and may be observed as cyclical infections.
Introduction of HPV into the anogenital area in children can be from several modes of transmission. Vertical transmission has been reported to be responsible for at least 20% of lesions. Horizontal transmission by caregivers in the first days of life is another modality of HPV contamination in newborns. There is also heteroinoculation by affected family members with common warts (verruca vulgaris) and autoinoculation from children who have a cutaneous or oral infection. Nevertheless, perianal and genital warts may be a sign of sexual abuse and must be investigated appropriately.
Codes
ICD10CM:B07.8 – Other viral warts
SNOMEDCT:
57019003 – Verruca vulgaris
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Corns and calluses typically arise on the plantar surfaces of the feet and between toes. These lesions lack the punctate black dots seen in warts. Paring of a wart often better illustrates this feature.
- Condyloma acuminatum
- Molluscum contagiosum can be differentiated by the smooth, domed surface with umbilication.
- Enlarged sebaceous glands or epidermoid cysts
- Seborrheic keratosis
- Pigmented nevus
- Compound nevus
- Nevus sebaceus
- Epidermal nevus
- Skin tag
- Prurigo nodularis presents as a pruritic lichenified hyperpigmented papule or nodule.
Best Tests
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Management Pearls
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Therapy
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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
References
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Last Reviewed:01/26/2021
Last Updated:01/26/2021
Last Updated:01/26/2021
Patient Information for Common wart in Child
Overview
Warts are growths of the skin and mucous membranes (inside the mouth or genitals) that are caused by a virus known as the human papillomavirus (HPV). Common warts (verruca vulgaris) are usually found on areas of the body prone to trauma, such as the elbows, knees, and hands. The virus causes thickening of the top skin layer. They are usually painless and go away on their own, sometimes taking a few months or up to a couple years to resolve.Warts are usually acquired from person-to-person contact. The virus is not highly contagious but can cause an infection by entering through a small break in the skin. In the same way, warts can be spread to other places on the body (self-inoculation). The virus can sometimes be transferred by touching an object used by an infected person, so family members should refrain from sharing towels and other personal items.
Who’s At Risk
Warts can affect people of any age, but they are most common in those aged 12-16 years. It is estimated that 20% of schoolchildren and about 10% of the general population have warts. Warts can affect any race / ethnicity. People with organ transplants or who are on chemotherapy have a higher incidence of warts due to their weakened immune system.Signs & Symptoms
Warts may occur singly or in groups and often have what appear as multiple small black "dots" at the surface from tiny blood vessels.- Common warts are rough, thick papules (solid bumps) ranging in size from 1 mm to over 10 mm, often on the hands, face, elbows, and knees.
- Filiform warts are long and narrow, like tufts of thread, and they are usually small at the base (1-3 mm). They often affect the face, eyelids, or nose.
- In lighter skin colors, warts may be pink, skin-colored, or light brown. In darker skin colors, warts may be pink, skin-colored, purple, brown, or gray.
- Warts can be covered with scale, which can be whitish, yellow, brown, or gray.
Self-Care Guidelines
Because warts can resolve on their own, it is not necessary to treat all warts. Additionally, treatment of warts may not always destroy them, nor will it necessarily keep other warts from appearing. Treatment can be painful, cause scars, and might need to be repeated, so it should only be done in cases where the warts are bothersome or interfere with daily life.- Over-the-counter wart removers (eg, Compound W) have a high percentage of salicylic acid and work by dissolving away the layer of skin infected with the virus. This treatment needs to be used daily and can sometimes be irritating to unaffected skin around the wart.
- Duct tape applied daily to the affected area can help remove warts. The tape should be very sticky and kept on for a few days. Some children may have a reaction to the adhesive on the tape.
- Over-the-counter freezing medications are available but have not been found to be very effective.
- Coupled with the above therapies, the wart should be soaked in warm water, and any loose skin should be removed every few days with a mild abrasive, like a pumice stone.
- Family members should avoid sharing personal items such as towels.
When to Seek Medical Care
Call a health professional if your child has:- Painful or bleeding warts.
- Warts on the face or warts interfering with daily life that do not improve with self-care.
- Warts on the genital or anal area.
Treatments
- Application of cantharidin (Ycanth), podophyllin (Condylox), tretinoin (Retin-A), or acid (Tri-Chlor).
- Destruction with freezing (cryosurgery), burning (electrocautery), or laser. These treatments are painful, though, and may be avoided in younger children.
- Application of imiquimod (Aldara, Zyclara), an immunotherapy agent, that triggers an immune reaction to destroy the wart.
Common wart in Child
See also in: External and Internal Eye,Anogenital