American Medical Association Family Medical Guide - American Medical Association [753]
Symptoms and Diagnosis
The common wart is a rough, hard, usually painless lump that contains small black dots (which are clotted blood vessels). It usually grows on the hands but can grow anywhere on the body. A common wart on the bottom of the foot is called a plantar wart and can cause pain when it is pushed into the sole of the foot by the weight of the body. Flat warts are small, smooth warts that often appear in large numbers on the face but can occur anywhere on the body. Genital warts (see page 480) are spread through genital, anal, or oral sex and can occur in the genital area, around the anus, and in and around the mouth.
See your doctor if you are older than 45 and develop a wart (and have never had warts before) or if you have warts that are painful or that bleed or itch; you may have another skin disorder, such as skin cancer (see pages 1068 to 1070). You should also see your doctor if you have facial or genital warts or if a wart doesn’t respond to treatment.
Treatment
Most warts eventually disappear on their own. The most common way to treat warts is to apply an over-the-counter wart remover. These medications either burn (using salicylic acid) or freeze (using a mixture of dimethyl ether and propane) the wart, destroying the cells containing the virus. But don’t use over-the-counter wart removers to treat facial or genital warts; these types of medications are too harsh for the face and genitals.
A painless but time-intensive way to treat a common wart is to cover it with duct tape for 6 days, plane the wart down with an emery board or pumice stone, and reapply duct tape. Repeat the procedure every 6 days for up to 2 months or until the wart has completely disappeared. Doctors think that the technique works by softening the wart and possibly stimulating the immune system to fight the virus. Because this method is painless, it is especially recommended for children.
If these self-help methods are not effective, your doctor may try removing the wart by cutting it off, freezing it with liquid nitrogen (cryosurgery), or burning it off with lasers (see page 1088) or a high-frequency electric current (electrocautery). Treatment may have to be repeated. Alternatively, the doctor may prescribe a drug called imiquimod (which is usually used to treat genital warts) to treat common and flat warts. This medication is applied to the wart every day to every 3 days. Bleomycin (an anticancer drug injected in small amounts directly into the wart), cimetidine (an antihistamine), and tretinoin (a vitamin A derivative used in some acne preparations) sometimes are used to treat warts that are difficult to remove.
Molluscum Contagiosum
Molluscum contagiosum (see page 125) is a skin rash caused by a virus that is spread by close or intimate body contact, including sexual contact, with an infected person. The virus produces small, waxy-looking growths on the skin. The infection is relatively common in children; in adults, it is usually transmitted sexually. Scratching can spread the virus from one area of the body to another.
Symptoms
At first, the growths are firm, solid, and flesh colored. Eventually, they become softer and pearly, usually with a depression in the center. In some cases, a white, cheesy or waxy substance drains from them. The growths can appear on the face, trunk, arms, or abdomen. When transmitted sexually, the growths usually appear on the genitals and upper thighs.
Diagnosis and Treatment
A doctor can usually diagnose molluscum contagiosum by its appearance. A sample can be taken from one of the growths for examination under a microscope (biopsy) to detect the virus