Warts are multiple skin growths that appear on the arms, elbows, legs, face, and even the genital area. They are round in shape, rise above the surface of the skin, bleed in case of mechanical damage and cause discomfort. Outwardly, such formations look quite harmless, but in fact their appearance indicates the presence of the human papillomavirus in the body.
Doctors' decision when such tumors appear is to remove them as soon as possible. This is the only way to avoid unpleasant consequences and completely get rid of the existing cosmetic defect. There are many ways to remove warts, each of them has certain characteristics and indications. Let's see what methods are used in modern dermatology and how to recognize the presence of warts on the body.
Important!
The information in this article cannot be used for self-diagnosis and self-treatment. You should always consult a doctor to establish the correct diagnosis and prescribe treatment.
What is a wart?
It is a benign, flesh-colored formation that indicates local proliferation of the epidermis with papules (bumps) or plaques. Simply put, such formations do not differ or slightly differ from the color of the skin, but rise above its surface and have a characteristic round shape.
Complications of warts include cracking of the surface, growth of the affected areas and joining the infection process. Also, certain types of growths are painful. But most often, patients do not think about the possible consequences and seek medical help for only one reason - the unaesthetic appearance of growths and psychological discomfort due to their appearance.
Warts usually do not degenerate into malignant tumors. Externally, however, they can be confused with certain types of malignant pathologies. Therefore, when such growths are detected, a doctor's examination is a mandatory measure to preserve health.
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Reasons for appearance
The cause of the appearance of warts is the presence of the papillomavirus (HPV) in the body. One of the symptoms of this infection is light-bodied neoplasms, which are often multiple.
According to statistics, up to 90% of the world's population is infected with papillomavirus. More than 100 types of HPV have been identified that can infect the skin and mucous membranes and trigger the development of lesions characterized by papillomatous growth.
Papillomavirus infection in the body does not always provoke the development of external manifestations. This is only facilitated by certain factors, including:
- avitaminosis;
- bad habits;
- pregnancy;
- endometriosis etc.
Moreover, the development of HPV can also occur against the background of a normally functioning immune system. It is worth noting that infection occurs through direct contact with an infected person. The most common way of infection is through sexual contact with a person infected with the human papillomavirus or through parent-to-child transmission. Also, the growths on the skin (i. e. warts) are themselves contagious. It is also known that the virus can penetrate the basal layer of the epidermis through microtraumas.
It is worth noting that HPV does not always cause warts, as it can occur latently (hidden). In addition, the appearance of tumors depends on the subtype of the infection that entered the body. The changes caused by the human papillomavirus are morphologically diverse, so only a doctor can make an accurate diagnosis.
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Types of warts
The human papillomavirus can cause the following formations:
- Common or vulgar (verrucae vulgares). The most common form, which occurs more often in children of preschool age (about 70% of cases). Growths with a rough surface of several millimeters. It can be yellowish or gray in color. At first, their shade often matches the tone of the skin, but then the formations begin to darken. Over time, they can increase in size, which causes great discomfort to a person. In addition, cracks around the wart are common. To the touch - rough and dense, covered with keratinized skin on top. The main localization is the fingers, the back of the hand, and in children, growths can also be found on the knees. It often happens that several clusters of small ones form around a vulgar wart, and over time the affected areas only increase in size. The formations are usually not painful, but in rare cases they can disappear on their own. But most often it is necessary to remove them in order to avoid injuries. These types of warts are caused by HPV types 1, 2, 4 and 7. Infection occurs through direct contact with the patient. Several factors predispose to infection: the presence of microtraumas on the skin, recent shaving, hyperhidrosis, excessive pressure on the skin due to clothing or shoes. Children often get infected at school, kindergarten or in the sports department. When identifying this type of tumor, it is important to carry out a differential diagnosis and exclude the presence of warty skin tuberculosis, keratoacanthoma and many other pathologies.
- Flat or young (verrucae planae verrucae juveniles). It is clear from the name of these tumors that they appear in adolescence or young adulthood. Their specialty is a slight protrusion above the surface of the skin, a round shape and a color that matches the shade of the skin. Keratinization is most often absent. The size of the growths is 5-8 mm. They can be single or multiple. It is found on the face, neck, and back of the hands. They may disappear spontaneously after 1-2 years. The differential diagnosis is made with lichen planus and molluscum contagiosum.
- Soles (verrucae plantares). A common form that, as the name suggests, occurs on the sole of the foot. Usually, this is the area of the metatarsals, the heel or the balls of the toes - the areas that are subject to the most pressure and friction. Such growths can reach a large size - up to 2 cm in diameter. Excessive friction can cause them to break and cause injury. They usually have clean edges and a rough surface. Under the keratinized skin, black dots are often visible - thrombosed capillaries. Color - yellow or brown. The reason for the appearance of such growths is HPV types 1 and 4. The pathological process can be superficial and deep. In the second case, warts cause discomfort and pain when walking, so they are always removed. The differential diagnosis is made with calluses and fungal skin lesions.
- Genital warts. This form of neoplasm is one of the common manifestations of HPV in the anogenital area. Condylomas are found on the genitals or near the anus, sometimes in the groin, armpits, near the mammary glands, and in the corners of the mouth. They come in different sizes and look a bit like cauliflower. They are flesh-colored and can be on a thin stem or on a wide base in the form of a knot. Such growths are quite "fragile", therefore they often bleed. It is transmitted sexually. Risk factors include the presence of sexually transmitted infections, frequent changes of sexual partners, disruption of the normal microflora of the vagina, pregnancy, as well as various internal factors (for example, vitamin deficiency). . Another characteristic is the simultaneous appearance of several genital warts. In men, such formations are often mistaken for a papular necklace of the penis. In women, the pathology can be confused with micropapillomatosis of the labia.
There are other, less common types of warts. The classification of formations takes into account the type of HPV causing their appearance, the nature of germination, size and external parameters. For example, A. N. Khlebnikova identifies 8 clinical types of warts. Many researchers identify several possibilities and divide them into small subgroups. Other common types of neoplasms include:
- Filiform warts. Thin horny growths that appear on the face: near the nose, mouth, eyes. It is usually diagnosed in older patients and may have a wide or narrow base. Very easily damaged.
- Giant Buschke-Levenshtein condyloma. This is a special type of genital warts that initially appears as a group of multiple papillomas. The growths are usually located in the area of the inguinal folds or the vulva, and over time, an extensive change develops involving the adjacent tissues.
- "Butcher" warts. This is a type of vulgaris warts that appears in people who often come into contact with raw fish or meat. These are cauliflower-shaped tumors, but flesh-colored.
- Cystic warts. A type of growth on the leg that appears as soft nodules with deep fissures. In case of injury, a white-yellow cheesy discharge appears.
Diagnosis of warts
In most cases, a visual examination and anamnesis are sufficient to establish the diagnosis. To confirm the conclusions and exclude other pathologies, a histological examination of the neoplasm cells can be performed.
If another infection is suspected, the doctor may prescribe additional diagnostic procedures. It is possible, for example, to perform an analysis to detect antibodies against the virus, CT or MRI.
In some cases, the treatment of warts depends on the cause of their appearance, more precisely on the type of human papillomavirus present. To determine the existing disease, a differential analysis of the scraping of the epithelial cells of the urogenital tract is performed.
Removal methods
Treatment aims to remove growths to prevent regrowth and recurrence. Modern treatment methods provide up to 80% efficiency. Drug therapy of patients is most often required in the case of genital manifestations of HPV, and includes the use of cytotoxic drugs.
Physical or chemical destruction methods are used to remove physical manifestations. More than 30 different treatment methods are described in modern medical literature, so it is very difficult to talk about a universal method. Yu. Yu. Stirschneider notes that many of the described techniques have a number of serious drawbacks (for example, incomplete removal of the root, the risk of developing intra- and postoperative complications, the development of various cosmetic defects). That is why the method of treatment is selected individually and only after a differential diagnosis.
The most popular treatment methods are:
- Cryodestruction. This method of removing warts involves exposing the affected areas to liquid nitrogen. Controlled tissue necrosis occurs, resulting in complete removal of the existing tumor. Cryodestruction can be performed by application (for warts up to 10 mm in diameter) and aerosol (necessary for growths growing deep in the tissue). The removal is done in one session, if necessary, the procedure is repeated after 1-2 weeks. This technique is used for a small number of warts (on average no more than 4-5 elements) and a small treatment area. The procedure is usually painless and effective, but the result largely depends on the doctor's professionalism.
- Electrocoagulation. Removal of the tumor layer by layer under the influence of electric current. The technique is considered more effective than cryodestruction, but it also has disadvantages: after removal, scars often remain on the skin. Therefore, this method is not used in cases where a good aesthetic result is important. However, large affected areas can be removed with the help of electric current.
- Laser annihilation. One of the most effective ways to remove warts is laser therapy. This method is preferred at our Altermed Aesthetic clinic in St. Petersburg. The growth is removed layer by layer: under the influence of a laser beam, the damaged tissue evaporates until it disappears completely. The exposure time ranges from a few seconds to 2-3 minutes (depending on the size and number of growths). The procedure allows the removal of warts, papillomas and condylomas without invasive effects. Due to the immediate coagulation of the tissues under the influence of the laser beam, the risk of secondary infection is eliminated. Therefore, the rehabilitation process is quick and uncomplicated.
- Radio wave therapy. This technique involves the use of electromagnetic waves of a specific frequency. The procedure is performed with a special device (the Surgitron device is often used). During the exposure, the tissues are heated, as a result of which the forming cells actually evaporate (similar to what happens during laser therapy).
- Chemicals. The use of salicylic plasters and lactic acid salicylic collodion cannot be called a modern treatment method, however, this technique is still used in some cases. For example, if there are contraindications for other procedures. Chemical removal is a complex process that requires repeated procedures and preliminary mechanical removal of the affected tissue.
It is very difficult to say clearly which method is better for removing warts. When choosing the technique, the doctor takes into account the type, size, number and location of the formations.
The concurrent medical history of the patient, the presence of chronic pathologies and previously used methods are taken into account. Studies with popular treatment methods have shown that laser destruction shows optimal results (76%). According to Yu. Yu. Stirschneider, these figures are higher than those of electrocoagulation (56%) and cryodestruction (44%).
Complications after wart removal are extremely rare. In general, consequences are possible after trying to remove the growth. In these cases, the patient experiences inflammation, the virus continues to spread through the skin, or a scar forms. So, if you find a wart or similar growth, do not try to cauterize or cut it off.