WART

Common Wart

• HPV types-1,2,4,27 and 57
• Commonly seen in young children and adults.
• Meat butchers, frequent immersion of hand in water are risk factors
• Papules with verrucous surface.
• Commonest site-Hands
• (Fingers and palms)
• Warts do not have dermatoglyphics

Verruca Plana

HPV types-3, 10, 28 and 41

• Risk factors-sun exposure, swimmers
• Common sites-Face, lower legs
• Few milimetres brown or skin coloured flat topped papules
• Koebnerisation seen

Palmo-Plantar warts

• HPV types-1, 2, 4, 27
• Seen at pressure points
• If paring is done-multiple small black points seen (dilated capillary loops)
• Myrmecia
• Mosaic type
• Differentiate from corn and callosity

Filiform and digitate warts

• Finger like projection

Periungual warts

• Seen in nail biters
• Recalcitrant to treatment

Genital Warts

• Low risk genital HPV types-6 and 11
• High risk genital HPV types-16 and 18
• Condyloma acuminata
• Few mm to cms in size
• Lobulated papules usually multifocal, cauliflower like mass may be seen in moist occluded areas
• Sites- intraurethral in men, mucosal surface of cervix or vulva, perianal skin, vulva
• Giant Condyloma acuminata (Buschke Lowenstein tumor)
• Verrucous carcinoma, may invade and metastasize to LN

Bowenoid paulosis

• Hyperpigmented papules or flat surface
• HPV types-16,18
• Sites- Penis, Perianal area, vulva