Verruca vulgaris B07

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 23.03.2024

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Common warts (e); Finger wart; Fingerwarts; hand warts; Hand warts; verruca vulgaris; Virus wart; Virus warts; Vulgar warts; Wart; Warts; Warts vulgar

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Ciuffo, 1907 (description of the viral genesis)

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Worldwide spread, frequent infectious disease caused by human papilloma viruses (see also wart) with formation of mainly acrally localized, regressive, hemispherical or flat, hyperkeratotically roughened papules and/or nodules on skin and mucosa.

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Human papillomaviruses (DNA virus); most commonly HPV1, 2, 4, 27, 57.

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Most common virus-related wart form. Transmission from person to person or through autoinoculation. Incubation period up to 20 months. The risk is increased if other family members also suffer from warts ( odds ratio 1.9).

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Occurs mainly in children, adolescents, young adults, often in acrocyanosis. Predisposing factors are hyperhidrosis, immunosuppression or atopic diathesis (children with atopic dermatitis seem to be more susceptible to viral inoculation). Autoinoculation is a typical phenomenon in children.

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Localized mainly on the hands and feet (poor circulation), see Verruca plantaris, see also Verruca perionychialis, infestation of the entire integument is possible. On the head often in the form of verrucae digitatae on the capillitium with filiform or finger-shaped extensions.

Clinical features
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Solitary but also to beds aggregated, hemispherical, 0.2-0.8 cm large, coarse, mostly skin-coloured or grey-yellowish papules, nodules or plaques with a verrucous, fissured surface. Development of daughter warts in the surrounding area by autoinoculation is possible. The clinical morphology is significantly influenced by the location of the warts, e.g. warts around the nose often appear as pedunculated or thread-like lesions. Warts located periungual (and subungual) often lead to onychodystrophies. They can lead to extensive tumorous vegetation. Such formations are therapeutically particularly problematic.

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Sharply defined epithelial nodules with strong acanthosis and clearly protruding hypergranulosis, sawtooth-like papillomatosis, powerful hyperkeratosis, which is interspersed with parakeratotic sections. Diagnostically groundbreaking are so-called koilocytes (HPV-infected keratinocytes with optically empty halo around the nucleus and basophilic inclusion bodies), which appear grouped in the upper parts of the epithelium. The epithelial valleys usually show a broad, very conspicuous hypergranulosis with clumped, deeply basophilic stained granules. The upper dermis shows different densities of lympho-histiocytic infiltrates.

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See below Warts (viral warts).

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Healing without scarring after weeks to years. Spontaneous healing is reported between 25% and 60% of cases, depending on the location and duration of the disease. Caution. Scarring due to surgical therapy is possible.

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In butchers(butcher's warts), HPV-7 can often be detected in warts, a virus that occurs very rarely in the rest of the population. HPV-7 belongs to the alpha-papillomaviruses and has been isolated from the oral mucosa of HIV-infected persons, from condylomas of immunocompromised persons and in China from warts of the interdigital spaces.

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  1. Betlloch I et al (2002) Verruca vulgaris surrounding a total graft following a burn in a child. Pediatric Dermatol19:369-370
  2. Ciuffo G (1907) Imnesto positiv con filtrado di verrucae volgare. Giorn Ital Mal Venereol 48: 12-17
  3. Iraji F et al (2002) Histopathology of skin lesions with warty appearance in renal allograft recipients. On J Dermatopathol 24:324-325
  4. Khanna N, Joshi A (2004) Extensive verruca vulgaris at unusual sites in an immunocompetent adult. J Eur Acad Dermatol Venereol 18:102-103
  5. Muzio G et al (2002) Treatment of non-genital warts with topical imiquimod 5% cream. Eur J Dermatol 12:347-349
  6. Penso-Assathiany D et al (1999) Warts, swimming pools and atopy: a case control study conducted in a private dermatology practice. Ann Dermatol Venereol 126:696-698
  7. Rübben A (2011) Clinical algorithm for the therapy of cutaneous, extragenital HPV-induced warts. Dermatologist 62: 6-16


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Last updated on: 23.03.2024