Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (42)

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

Common wart in Child

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

Synopsis

Common warts, also known as verruca vulgaris, are caused by the human papillomavirus (HPV), most frequently HPV types 1, 2, and 4. Infection is usually at sites prone to frequent trauma such as fingers, hands, knees, and elbows, but common warts can occur on virtually any epidermal surface as well as mucosal surfaces. Warts may be pruritic, and scratching can produce a linear array of lesions via autoinoculation. Widespread, persistent lesions may be a clue to an underlying inherited or acquired immunodeficiency.

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

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

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

References

Subscription Required

Last Reviewed:01/26/2021
Last Updated:01/26/2021
Copyright © 2023 VisualDx®. All rights reserved.
Patient Information for Common wart in Child
Print E-Mail Images (42)
Contributors: Medical staff writer

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.
Copyright © 2023 VisualDx®. All rights reserved.
Common wart in Child
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 © 2023 VisualDx®. All rights reserved.