Verruca vulgaris is a skin condition characterized by hyperkeratotic papulonodules. They are commonly seen on hands, arms, and legs and have a glabrous appearance. The human papillomavirus (HPV) causes these lesions. In rare cases, medical professionals can misdiagnose and treat them incorrectly. Here’s an example of a chance of giant periungual verruca vulgaris: a 50-year-old male patient who underwent surgical excision.
Symptoms
Common warts account for almost 70% of all viral warts. Although common warts usually go away independently, some may require treatment. Treatment aims to kill the wart and stimulate the immune system to clear it out. The treatment may last from weeks to months, and warts often recur after treatment. Treatment methods include salicylic acid, freezing, laser treatment, or 5-fluorouracil, an antiviral drug.
The leading cause of verruca vulgaris is the HPV virus. This virus is passed from one person to another through direct skin-to-skin contact or by autoinoculation with infected skin. Warts also spread viral particles through contaminated objects or clothing and can remain contagious for a long time without treatment. HPV is highly infectious while it is present on the skin and can remain active for years without treatment.
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Warts are small, scaly lumps that form on the skin. These lumps may be rough to the touch and grow faster than usual. The human papillomavirus (HPV) causes warts, but no cure exists. Most people naturally fight off the virus within two to three years, but it can reappear in the same area. Warts on the hands can be uncomfortable and can spread quickly.
Common Warts: Location and Affected Populations
People commonly find common warts on their hands and feet. Typical warts may appear solitary or in groups. They are commonly found on the hands, feet, and around nails. Other types of warts, such as Myrmecia, occur on different body parts. Even though there are many types of common warts, their most common location is the hands and feet. The disease can also affect males.
Verrucas can be painful because they occur in the body’s high-pressure areas, such as the feet. Patients should avoid walking or standing on warts because they may bleed when scratched. They may also affect one’s gait, resulting in pain in the back and legs. If not treated in time, the condition may progress into skin cancer. So, how do you get rid of verrucas?
The VA examiner’s findings suggest that the Veteran may have ichthyosis, a separate diagnosis from eczema. However, it is less likely than not related to active duty service. Since the Veteran has no underlying medical condition, the VA granted him a service connection for eczema and verruca vulgaris. The RO then combined the two. Whether a military illness or injury causes ichthyosis is not known.
Diagnosis
The most common presenting symptom of verruca vulgaris is painful, cauliflower-like papules. They are papillomatous and hyperkeratotic and may range in size from 1 mm to 1cm. They may be single or clustered. The rash is typically painful. Pinpoint bleeding following debridement or disruption of dermatoglyphic skin lines may be prognostic.
Seborrhoeic keratosis, similar to verrucas but with a different cause, often leads to confusion with verruca vulgaris. However, while koilocytes are not required to diagnose verruca vulgaris, they definitively implicate HPV. Medical professionals can find koilocytes in the top layers of the skin, known as the epidermis. They have a unique look with empty spaces and nuclei that resemble raisins in the keratinocytes.
Verruca vulgaris is a common skin disease that affects young children and adolescents. The appearance and location of verruca vulgaris can affect a person’s quality of life, particularly when other symptoms accompany it. Infection with human papillomavirus (HPV) is the most common cause of verruca vulgaris, but there are also distinct types of HPV.
One patient reported an unusual case in which a rose tattoo surrounded seven warts on his left arm. He had no other verruca before, but they acquired the rose tattoo two years before the appearance of warts. A biopsy confirmed the diagnosis, and the patient’s father was overwrought at removing the tattoo site. He and his father could not agree on treatment.
Diagnosis and Treatment of Verruca Vulgaris
After debulking, the verruca returned and became 3.5 cm in diameter. Topical cidofovir failed to resolve the molluscum contagiosum. Diagnosis of verruca vulgaris continues to be challenging, but proper treatment is essential to alleviate the symptoms. The following therapies are effective in treating verruca vulgaris. You may not have an itch, but a wart is uncomfortable and painful.
The initial biopsy showed evidence of the presence of HPV. The biopsy revealed HPV-positive lesion cells. A biopsy of the lesion’s edge gave additional confidence in the diagnosis. Positive HPV capsid protein was detected. Frequently, medical professionals base this diagnosis on the patient’s history of the initial fleshy lesion. However, this method of diagnosis is only sometimes reliable. An appropriate clinical examination must accompany it.
A 48-year-old man with planar warts on his forearms underwent topical therapy with a green tea leaf extract. Although the results were mixed, the treatment did help some patients. It did not improve the itchiness associated with verruca vulgaris or the presence of a skin infection. However, a case with a history of SOD could indicate verruca vulgaris.
In another case, a 33-year-old man with HPV type 27 underwent a biopsy. The patient, who was on antiretroviral therapy, confirmed the diagnosis. We also conducted a biopsy in this case. In case 19, we found at least 20 warts and three or more on the surrounding normal skin. The human papillomavirus infected the patient, as revealed by the biopsy.
Treatment
One case report described the surgical excision of multiple pinkish papillomatous masses from the external auditory canals of a 32-year-old male patient with various ear nodules. We describe this case in detail. The patient had received no specific treatment, but the masses increased in size over time. Histopathological examination revealed a central fibrovascular core and keratinizing squamous epithelium.
Bleomycin was diluted with 1% lidocaine to make a solution of one unit per milliliter. They blanched the verruca completely by using a one-mL syringe with a 30 gauge needle to inject the solution. The doctor repeated the injection twice, injecting 0.5 mL at the first injection and 0.2 mL a month later. Bleomycin injections may effectively treat verruca vulgaris when the verruca nodules haven’t relapsed after two or three months.
Cryotherapy is the first-line treatment for verruca vulgaris. This method involves applying liquid nitrogen directly to the verruca to induce a cell-mediated response, which kills the virus. Newly-available over-the-counter cryotherapies are not as cold as liquid nitrogen. However, they do cause side effects, including halo nevi and hypopigmentation. It is why patients should consult with their physician before choosing this treatment.
Alternatives to Surgical Excision for Verruca Vulgaris Treatment
There are other ways to treat verruca vulgaris, like creams and lotions, freezing it with cryotherapy, light therapy, or laser therapy. Healthcare providers prefer surgical excision for patients with large numbers of plantar verrucae. However, there are risks associated with this treatment, including EAC stenosis and scarring. Although surgical excision is the most effective treatment for this skin condition, it is essential to choose the appropriate approach, which includes both cosmetic and medical considerations.
Laser treatment is an excellent option for treating verruca vulgaris. Lasers use infrared light and have an overall cure rate of forty to seventy percent. Limited evidence supports these treatments, as many published studies lack randomization and control. Only after consulting with your doctor should you undergo these laser treatments. If you want to avoid surgical treatment, consult your physician.
A retrospective study in China summarized the clinical results of the Chinese traditional medicine YIKEER on a group of patients with verruca. Exclusion criteria included pregnancy, lactation, allergic skin diseases, severe skin diseases, and syphilis. These patients received the medication daily for five or six days, followed by a rest period of three or four days. To see if YIKEER was adequate, we gave patients a topical solution mixed with sea buckthorn oil for three or four days. Each session involved a whole procession.
