Warts - symptoms and treatment

What is a wart? In this article, we analyze the causes, diagnosis and treatment of a 37-year-old experienced dermatologist.

Diagnosis. Causes of the disease

WartsThis is a mild skin lesion in the form of overgrowth of the epidermis, localized by papules (nodules) or plaques.

Warts range from 7-12% in adults and 10-20% in school-age children.

Warts are very similar to other skin plants. Normally, a person cannot diagnose the disease on their own, so a dermatologist should be consulted to make a diagnosis.

Human papillomavirus causes warts. The type of virus affects the type of warts that can develop. Thus, each type of human papillomavirus is characterized by tissue infection during localization.

HPV type	Selected localization	Types of Warts
1	Feet, knees, palms, hands, fingers	plantation and palmar warts, rare common warts
2, 4	Hands, fingers, knees, less - feet	Simple warts, sometimes plantation, palm and mosaic warts
3, 10	Needle, hands, face	Flatworms
7	Hands and fingers	Warts of Batchan
5, 8, 9, 12, 14, 15, 17, 19-24	Face, arms, front torso	Veridermodysplasia verruciform

Viral infections are usually transmitted through contact - through infected and unhealthy skin (for example, by hand) or indirectly (by hand, cabinets, toys, etc. ). Therefore, you can be infected with the human papillomavirus in various places - on public transport, at school, at work, at home, in public places and in humid environments (swimming pools, saunas, gyms). Minor damage to the epidermis, which includes viruses, and inflammation of the skin can lead to infection.

He also contributed to the formation of warts:

• immunodeficiency (including HIV infection);
• warm and humid environment;
• need for professional contact with meat and fish ("butcher's wart").

Some types of human papillomavirus are transmitted from parents.

However, shrubs and frogs cannot infect us, despite the horrific events we dreaded as children - one of the most popular myths about this disease.

If you notice any of these symptoms, talk to your doctor. Do not make your own medicine - it is dangerous for your health!

Wart marks

Symptoms vary depending on the type of wart.

General wart:

• Normally colored round dense papules, 1-10 mm and larger.
• The surface of the papule is covered with cracks.
• If the papule is on the finger, the print will be lost and distorted. The same can be said of the date palm.
• Normal warts are located separately or in several parts - they usually appear on the injured area (hands, fingers, knees).
• If you look through a dermatoscope, your doctor may see small brown dots - clogged capillaries. Patients often refer to these thoughts as "root. "This is the main symptom for the doctor: a dermatologist can use it to differentiate heat diseases from other similar diseases (such as molluscum contagiosum and keratoma).

plantation (horned) wart:

• Usually, the main symptom that causes a patient to see a doctor is pain when walking and walking.
• Such warts are usually located on the feet.
• When you see a doctor, you usually see keratinous, uneven patches of normal color, but in the first stage you may see a smooth, smooth papule. With keratinization, capillaries can be seen only after the keratinized layer of skin has been removed.
• The skin of the heel is distorted.
• Planta warts are usually solitary, but there are also 2-6 warts;
• These warts are often mixed with corn (especially dry) - a description of a common problem in patients.

Flat wart:

• It looks like a normal, pink or brown round, transparent, smooth papule 1-5 mm in size.
• Hands, warmth, often appear on your face.
• Such warts are always present, they are located in groups.

Epidermodysplasia verruciform:

• Normal, large, round, numerous mixed juices of pink or brown color.
• It usually appears on the face, arms, and forehead.
• Possible keratoma, finger and skin cancer.

Wart pathogenesis

When a person enters the body, the human papillomavirus can remain in a latent state for a long time - the person usually does not know it exists. When favorable factors for the virus appear, they "multiply" in the epithelium, leading to tissue changes.

Unlike other viruses, human papillomavirus does not destroy epithelial cells on its own - they die on their own, naturally in the process of keratinization and exfoliation.

The spread of infection is influenced by local factors and the state of the immune system. For example, people with HIV or kidney transplants may develop warts. In addition, these tumors are difficult to treat. With normal immunity, the virus does not affect the deeper layers of the skin, so many people get warts on their own after a few months.

The main stage in the formation of warts is the division of cells by the virus and the acceleration of their growth. This rapid metabolism leads to thickening of the skin layers. Because tissues grow in a small area, they are called bones.

Classification and developmental stages of warts

There is no generally accepted classification of warts. However, there are several common varieties:

• The common leech
• Plantar warts- appear on the soles of the feet, cause pain and therefore require treatment. Skin trauma due to uncomfortable, narrow, shoes contributes to the development of such warts.
• Flatwormsare more common in young people and adolescents. This is due to the unstable hormonal background of youth, which affects the whole body. Flat warts are usually almost invisible.
• Senile wartsare common in the elderly. They usually appear on the part of the body covered with clothing, but can also appear on the face and hands. If there is no discomfort, such warts should not be treated - due to the slow metabolism, the healing process may be slower in the elderly than in the young.

Other authors have several differences from this type of wart:

• Mosaic warts(HPV 2, 4) are tumors of the palms and soles. They are foci of hyperkeratosis, p. a. thickening of the cortex covered with deep layers (usually on the forefoot).
• Mystical Warts(HPV 60) is a rare type of foot neoplasm. It is a soft knot with cracks. When opened, a cheese-like white-yellow discharge appears.
• Filiform wartsare thin-horned mice near the mouth, nose, or eyes.
• "Butchers" Warts(HPV 7) - Occurs on the hands and fingers of people who come in contact with meat and fish. It has been shown to be a hypertrophied new tumor that resembles cabbage but has a normal color.

In addition, the types of warts vary depending on their location.

Thus, anogenital warts are new tumors, such as tumors that form in the genitals (especially in areas where the skin has penetrated the mucous membrane). They are usually caused by HPV types 6 and 11.

Wart Problems

The main reason patients with warts go to the doctor is a lack of quality of life, self-confidence and aesthetic development, which can develop many complexes. As a result of war, the surface of the wart may rupture and become infected, as well as some types of walking can cause pain while walking.

Skin warts usually do not turn into malignant tumors, they are very harmless, but in rare cases, they can occur even in people with weakened immune systems.

When you try to remove the tumor on your own, other problems arise. In this regard, aesthetic defects in the form of inflammation and scars, as well as the virus can spread further through the skin, so after removing a wart in the morning, a person can wake up with a few new ones.

Warts are a completely different disease that can be hidden without the advice of an experienced doctor.

Wart Diagnosis

An examination (clinical picture) and anamnesis (medical history) are usually sufficient to make a diagnosis.

To confirm the diagnosis, the doctor may perform a histological examination - the study of new cells.

Differential diagnosis is very important to distinguish warts from other diseases. For example,common wartsshould be distinguished from the following diseases:

• Molluscum contagiosumis common on the body and genitals, and on the hands and feet. It is a hemisphere that leaves an impression on the earth, and when pressed on both sides, the white "liver" is released.
• Epidermal vertebral nevus- usually a single person, from birth. It rises above the skin and is usually covered with hair.
• Basaliomais a roller-shaped tumor of the embryo covered with a central membrane. Characteristic of the elderly.

Palmar-plantar wartsshould be distinguished from the following diseases:

• Keratoderma- keratinization and inflammation of the skin. There are no clogged capillaries.
• Palmar-plantar syphilis- benign tumors, perforation of the skin along the periphery. The guarantor has a positive reaction
• corn- usually painless, can only cause pain when pressed vertically.

A doctor should differentiate other types of warts from a number of other diseases. If another pathology is suspected, it may make an additional diagnosis (e. g. , antibodies to the virus, CT or MRI).

Wart treatment

Warts are treated for aesthetic purposes and to improve the patient's quality of life. It can be prescribed by a doctor only after examination and accurate diagnosis. Independent efforts to get rid of warts are not possible because there is no medical knowledge and the necessary equipment does not allow to accurately diagnose the disease, and diseases that occur after such "treatment" are more common than recovery.

There are several ways to treat warts. All of them are usually performed under the supervision of a doctor, and some - only in the treatment room of the clinic.

Chemical curing

Milk-salicylic colodion and salicylic stains are used to get rid of warts. The percentage of drugs and the method of their use (long-term spots, applications, etc. ) depends on the prevalence and spread of the neoplasm.

Solutions of zinc and 2-chloropropionic acid can also be used. In this case, the chemical composition is applied to a pre-cleaned surface, which remains on the wart until it changes color (depending on the type of wart). The procedure is repeated several times after 7, 14 and 21 days. Before each procedure, the tissue is removed mechanically.

Another chemical method is a combination of nitrogen, vinegar, oxalic, lactic acid and copper nitrate trihydrate. In this way, relatively small tumors are treated - up to 5 mm. The decision to change the color of the wart remained. After 3-5 days, the patient is scheduled for the next appointment, and if necessary, he is assigned a second procedure in 1-4 weeks.

Cryodestruction

This method involves freezing the wart with liquid nitrogen: a moistened swab is applied to the affected skin for 1-5 minutes (pressing a few millimeters of round tissue). Some injuries require multiple treatments over a four-week period.

The main disadvantages of cryodestrus are its pain and delayed effect compared to other methods, it is enough to remove only one procedure.

Electrocoagulation

Warts are removed in layers by electric current. This operation is performed under local anesthesia.

This method is more effective than creodestruction, but it has one drawback: the electrocardiogram often leaves scars where warts are removed. For patients trying to correct a cosmetic defect,this method is not the most suitable.

Laser destruction

The laser also destroys the warts in the layer. The light indication lasts from a few seconds to three minutes, depending on the size of the skin. The scar is then removed and the bottom of the wound is cleaned again with a laser. The patient is then shown how to deal with the injury. The operation itself is performed under local anesthesia.

Radio Wave Surgery

Radiofrequency surgery is one of the most modern and gentle methods of removing some malignant tumors, including warts.

This method is based on the generation of electromagnetic waves of different frequencies: from 100 kHz to 105 MHz. During the procedure, the tissues resist the waves, so the cells that heat the skin release molecular energy. Under the influence of heat, the cells actually evaporate - they are carefully cut. At the same time, the affected tissue is not affected by any mechanical forces.

The advantage of this method is:

• security;
• Quick wound healing;
• good cosmetic effect - removes scars and scars;
• relative painless - local anesthesia is used before minor surgery;
• Eliminate secondary infection by automatically disinfecting the electrode when the device is switched on.

The effectiveness of this method is known all over the world, but it is difficult to find a clinic that uses radio wave surgery.

Which treatment method to choose

All of the above methods have several drawbacks:

• For the first two weeks, the operating area becomes uncomfortable - the tissues darken. This should be taken into account if the warts are on visible parts of the body (such as the face).
• Unpleasant odor and some degree of pain during surgery.

In addition, there are contraindications to each of these methods, which you should know about in advance in consultation with a dermatologist.

However, the main drawback is thatis likely to recur, especially if warts are widespread. With each of these methods, doctors will no longer fight the root cause of the disease, but the consequences will not curehuman papillomavirus..

Therefore, the therapy focuses on:

• or removal of tumors at the site of infection;
• or to stimulate the immune response against the virus;
• or a combination of these relations.

Destructive methods of treatment are commonly used. Their efficiency reaches 50-80%.

Usually, childhood is not opposed to surgical treatment. Therefore, many of them (including radiosurgery) are also used to treat warts in children. Chemical removal of the surface is due to the occurrence of adverse reactions to the substance.

What to do after the operation

Remember to follow your doctor's advice on any of these operations.

After removing the tumor with one of these methods, the doctor will usually prescribe a cleansing treatment. It is forbidden to remove the "shells", irrigate the wound and expose it to direct sunlight.

If a patient is constantly affected by warts, he should consult an immunologist - this may require drug therapy, which increases the resistance of the immune system to the manifestations of human papillomavirus.

prediction. Prevention

If the patient is not immunocompromised, the wart may go away on its own, but it can take a long time - from a few months to several years. Thus, in 65% of cases, the wart will regress on its own within two years. If the wart is still present after two years, it is recommended to remove it. It is recommended to remove some plants immediately.

With normal immunity and the right method (depending on the size and type of wart), you can remove pathogenic tissue and achieve a good cosmetic result. The immune system is weakened, and the papillomavirus, which remains in the human body with other factors, causes the disease again.

There is nothing specific about disease prevention. But is infection so inevitable?

You can reduce the virus if you follow a few rules:

• Avoid walking barefoot in public places (swimming pools, outdoor showers, gyms) if your skin is injured and infected.
• Choose quality shoes and change them often. Try to keep your feet dry. Heat and humidity are excellent progenitors of human papillomavirus.
• To prevent external worms, go to a certified nail specialist and make sure they are using sterilized instruments.

According to the World Health Organization (WHO), the quadrivalent vaccine against human papillomavirus is more effective in preventing anogenital warts. There are currently no vaccines to prevent other types of warts.

If you have a wart, don't try to clean it up and cut it off - the virus can spread to the skin and spread further. After such a "removal", you can wake up in the morning with ten instead of one wart.