Warts are due to virus infection of the epidermis and are contagious.
The viruses responsible are different antigenic types of human papilloma
virus. Warts are among the commonest of disorders and luckily rarely
cause any significant threat to health. However, they are regarded
as ugly and excite the usual distaste and revulsion associated with
any disorder of the skin. Consequently they elicit a variety of
illogical responses from teachers and local authorities, including
the banning of children with plantar warts from swimming baths and
from the gymnasium. For every visible plantar wart there must be
many more that are not seen and exclusion seems a highly impractical
way of preventing the spread of this disorder. lt seems even °more
illogical when no attempt is made to prevent children who have had
gastrointestinal or respiratory infections from swimming. In my
view the obvious benefits that result from communal exercise far
outweigh the minor hazards of wart infection, bearing in mind that
these lesions are self-limiting and do not require heroic efforts
at removal. They are anyway notoriously stubborn in resisting treatment.
Viral warts can become a major nuisance for doctors is a good idea
to develop a treatment policy towards them.
First, make sure that
what are presented as warts are in fact viral warts. Beware of the
solitary wart in the elderly as squamous cell carcinoma can present
as a solitary warty nodule. They can also be confused with solar
keratoses or seborrhoeic warts. .
Perianal or genital warts in the
sexually active age groups may be what they seem but may also be
a manifestation of secondary syphilis (condyloma lata). The heaped
and slightly warty lesions of secondary syphilis are usually soggier
and more prolific than ordinary genital warts. In addition there
are usually other signs of syphilis present.
In children or young
adults, wart-like lesions that are small, dome-shaped, whitish papules
with a central warty spot are probably the lesions of another virus
infection molluscum contagiosum.
In most cases warts resolve spontaneously, so that whatever
you do may appear effective. Unfortunately their resolution
is unpredictable and some warts seem to take forever to disappear.
The old wives' tales of warts vanishing after they have been
bought for a penny or after burying a steak in the garden or
after some other equally bizarre magical technique are (at least
partially) explicable on the basis of this tendency to spontaneous
regression. However, practitioners should try especially hard
to clear some warts before natural resolution in certain situations.
