Warts - Causes, symptoms and treatment. MF.
A wart is a benign skin formation consisting of a connective tissue and covered with epithelium. Warts are common in both men and women, are found in childhood, adolescence, adulthood and old age. There are several types of warts:
• vulgar or common warts;
• flat( juvenile, juvenile) warts;
• plantar warts;
• senile wart;
• genital warts.
Causes of the appearance of warts.
Warts appear due to infection of one of the varieties of human papillomatous virus, which is transmitted by contact( for example, when shaking hands, walking barefoot in public places, swimming in the pool, using shared showers) or through household items.
The incubation period lasts from 6 weeks to 6 months.
But for simple virus infection a simple contact is not enough, there must be predisposing factors. The latter include microtraumas of the skin, maceration of the skin( for example, increased sweating of the hands and feet), immunodeficiency, which can be indicated by frequent colds.
Symptoms of various types of warts.
Any wart has the form of a papule. Papula is a lifeless formation on the skin that rises above its surface. So, when we have decided on the terminology, we will consider the main varieties of warts.
Conventional or vulgar warts are rounded papules, the size of a pinhead to a pea. The surface of such papules is uneven, dry( horny), rough, covered with villi, papillae and striated with cracks. The color of vulgar warts may not differ from normal skin or varies from yellowish-brown to dirty-gray. Usually they are located on the back of the hand and fingers, can have a narrowed base - leg. In some cases, the warts can merge, forming a large, tumorous, tuberous element. Usually they are painless, but with constant trauma they can become inflamed and cause pain. A typical appearance of them is shown in the figure below.
Conventional or vulgar warts
Flat( juvenile or juvenile) warts are papules slightly elevated above the skin surface and have a smooth, flat surface that can be covered with small scales. Their sizes vary from pinhead to lentil. The color of such formations may coincide with the skin color or have a dark yellow or bluish tinge. The favorite localization of flat warts is the back surface of the hands, the area of the wrist joints, the neck and the face. A characteristic feature is the multiple eruption of elements. Juvenile warts usually do not cause subjective sensations. A characteristic picture of flat warts is presented in the photo.
Flat( juvenile or juvenile) warts
Plantar warts are markedly morbid, in appearance they resemble corns, yellow. They can both rise above the skin, and take the form of a pit, at the bottom of which are visible bundles of papillae, and the outer edge of such a pit is formed of horny layers. They are located on the sole of the feet in the places of greatest pressure and friction. When removing the stratum corneum, which is easily crumbled, threadlike, soft, juicy, bleeding papillae( the so-called papillomatosis) are visible in the central part of the warts.
Star wart( seborrheic keratoma, seborrheic wart) is a benign epithelial tumor that occurs in old age, has a slow growth and takes its final appearance for decades. At first, a small spot of brown color appears, which gradually increases, reaching up to 6 cm in diameter. Its surface is covered with fat, easily removable crusts. At the end of its growth, the keratoma rises above the surface of the skin, acquires a more intense dark brown color, the crusts become denser, cracked cracks. Older warts are usually located in the closed parts of the body, but they can also appear on the face, scalp, neck and limbs.
The photo shows multiple back keratomas.
Genital warts or genital warts are usually located in the coronary groove of the penis, on the inner leaf of the foreskin, at the entrance to the vagina, in the anus, less often in the groin-femoral folds, in the armpits and under the mammary glands. They remind cauliflower or a cock's comb. Genital warts should be distinguished from manifestations of secondary syphilis - wide condylomas. The latter are more dense and located on a wide solid base.
The diagnosis of a wart is based on a clinical picture, no additional examination is required.
Diseases reminiscent of warts.
Warts can be confused with molluscum contagiosum, warty red lichen planus.
Molluscum contagiosum is the result of infection with a smallpox virus. Outwardly it is a semi-spherical formation, of a dense consistency, semi-transparent, slightly shining with an umbilical impression in the center, pinkish in color or not different from the surrounding skin. It reaches the size of a pinhead to a pea. When pressed from it, a grayish-white, mushy mass is allocated. There is 3 months, and then spontaneously disappears.
With a warty red flat lichen, nodules are brownish-violet with gray horny scales, towering above the skin, very reminiscent of warts. A distinctive feature is the multiple lesions of the shins and the rear surface of the feet.
Treatment of warts.
The treatment is suitable individually depending on the size, location and type of warts. Vulgar, flat and plantar warts can spontaneously disappear.
Today there is a rich arsenal of funds to get rid of warts. It includes: electrocoagulation, cryodestruction, laser removal, surgical removal, radio wave surgery. Locally, 10% salicylic acid is used in the collodion, especially with plantar warts.
The best method for treating vulgar warts is cryodestruction. For this purpose, use liquid nitrogen or carbon dioxide. Carbon dioxide is used in the liquid state in which it is stored in special cylinders at a pressure of 60 atmospheres. When released from a cylinder at room temperature, it turns into a snow-like mass for a few seconds with a temperature of -70 degrees. This snow mass is filled with glass tubes of different diameters under the size of the wart and after applying to it, squeezed out of the tube with a wooden stick. After the application for a time sufficient to freeze the tissues, the tube is removed. The procedure is painless and easily tolerated even by children.
Freezing with liquid nitrogen is carried out in a similar way, however, using a piece of cotton wool wound on a thin wooden stick, which is immersed in a vessel with liquid nitrogen and immediately applied to the wart. The time of application is decided individually.
After the procedure, a bubble forms after a while. It can not be opened, it needs to be lubricated with a solution of brilliant green. After the bubble burst, the crust is not removed, since under it there is healing.
Often after removal of the largest( maternal) warts, all others also pass.
From folk remedies, lubrication 2 times a day with fresh milky juice of celandine - viscous, orange colored liquid, which is released when cutting stems of the plant.
Plantar warts are difficult to treat conservatively. Therefore, after cryotherapy often have to excise them under local anesthesia.
A separate place is occupied by the papilloma of the eyelids. Only the ophthalmologist deals with the treatment of the latter. The use of folk remedies in this case is unacceptable. Cryotherapy with such a localization of warts is not used because of the danger of damage to the eyeball. From the whole arsenal of methods of treatment, till now the main place is occupied by the removal of papilloma by acute route under local anesthesia - the neoplasm is excised with an eye scalpel and sent to a biopsy. In this way, it is possible to remove the papillomas both on the outer surface and on the edge of the eyelid. After surgery, a bandage is applied to the eye to stop bleeding. A day after the operation, the wound is lubricated with a solution of brilliant green until the crust leaves and full epithelization.
Complications of warts.
With prolonged friction and injury, inflammation may develop. Warts are extremely rare.
Thus, the purpose of treating warts is cosmetic. Currently, there is a huge number of cosmetology centers, where a wide range of modern equipment for wart removal is offered. Be healthy and beautiful.
Surgeon-physician Tevs DS