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Flat wart - External and Internal Eye
See also in: Overview
Other Resources UpToDate PubMed

Flat wart - External and Internal Eye

See also in: Overview
Contributors: Gabriela Ulloa MD, Loren Krueger MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Flat warts (also known as verruca plana and plane warts) are 1-3 mm, round or oval, slightly raised, smooth papules induced by human papillomavirus (HPV) types 3, 10, 28, and 49. Flat warts are commonly painless and can be yellowish-brown, flesh-colored, or pink. They may appear singularly, in clusters, or in a linear arrangement. Flat warts typically present on areas of the body that have contact with other people and objects, such as the face, arms, hands, and feet; however, they can appear anywhere on the body. Flat warts are commonly seen on the face and near the eye due to autoinoculation. Hands commonly touch the periorbital skin, which can lead to the spread of flat warts.

The warts arise from benign strains of HPV and are not known to cause cancer. They are contagious and spread easily over the body. Transmission is commonly via person-to-person contact or via fomite. Existing skin trauma (ie, cuts, scratches, burns, eczema) predisposes patients to contracting HPV. A person with flat warts may spread the warts to a different part of the body (autoinoculation) through trauma to the skin such as scratching or shaving.

Children, young adults, and immunocompromised patients are most susceptible.

While warts are normally self-limited in children, they may be difficult to treat in adults. Longer periods of treatment are usually necessary for adults.

Codes

ICD10CM:
B07.8 – Other viral warts

SNOMEDCT:
240539000 – Flat wart

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Around the eye:
  • Common wart – Can appear around the eyes, may have filiform appearance.
  • Seborrheic keratosis
  • Actinic keratosis
  • Molluscum contagiosum – The lesions of molluscum contagiosum are commonly found in children like flat warts, but they are typically more raised (dome-shaped) and appear umbilicated.
  • Epidermodysplasia verruciformis – A genetic disorder characterized by diffuse flat warts and a high potential for squamous cell carcinoma transformation. Consider this when evaluating a patient with diffuse flat warts. Evaluate for a family history.
  • Syringoma – Flesh-colored papules around the eyes.
  • Trichilemmoma
  • Trichoepithelioma
  • Hidrocystoma (see Apocrine hidrocystoma, Eccrine hidrocystoma)

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:04/02/2018
Last Updated:04/19/2018
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Patient Information for Flat wart - External and Internal Eye
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Flat wart - External and Internal Eye
See also in: Overview
A medical illustration showing key findings of Flat wart : Tiny papules, Hyperpigmented papules
Clinical image of Flat wart - imageId=1881660. Click to open in gallery.  caption: 'Many discrete, pink and light brown, flat-topped, verrucous papules scattered over the dorsal hands. Note the linear arrays of warts indicative of autoinoculation.'
Many discrete, pink and light brown, flat-topped, verrucous papules scattered over the dorsal hands. Note the linear arrays of warts indicative of autoinoculation.
Copyright © 2024 VisualDx®. All rights reserved.