Warts with hair growing from them

US Pharm. 2011;36(8):15-23.

Patients often ask the pharmacist for advice about warts. It is imperative to inquire about the location and appearance of the lesions. Warts in some locations (e.g., hands, feet) can be self-treated, but warts in other areas (e.g., face, mucous membranes, genitals) require referral to a physician.

Contents

Etiology of Warts

An estimated 16% of the general populations suffers from warts.1 Warts, or papillomas, are caused by a group of viruses known as human papillomaviruses (HPVs).2,3 These double-stranded viruses stimulate basal cell division to produce lesions that are generally located in the upper epithelial tissues.1 There are more than 150 related viruses and over 200 subgroups represented in this group, but not all are responsible for causing warts.1,2 Warts on the hands and feet are not transmitted as readily as sexually related HPVs, usually being caused by HPV subtypes 1, 2, 4, 27, and 57.2,4 Thirty-five types are known to infect the genital tract, most commonly subtypes 16, 18, 31, 33, 45, and 59 for squamous cell carcinoma and adenocarcinoma of the cervix.4 Types 6 and 11 are commonly associated with warts in the anogenital area.4

Sexually transmitted HPV types that tend to produce cancers are referred to as high-risk or carcinogenic HPVs.2 HPV has been linked to cervical, anal, vulvar, vaginal, penile, and oral cancers.

Other animals can carry papillomaviruses, but they are specific to that species. Contrary to superstition, frogs and toads cannot carry the virus and thus cannot pass the virus on to human hosts.1

Epidemiology of Warts

Most types of warts exhibit an age-related epidemiology, occurring with greater frequency in those aged 12 to 16 years.1,5 There is also a different risk by gender, with females developing warts more often and earlier in life; incidence peaks at 13 years in females, but at 14.5 years in males.1 Immunodeficiency can also increase the risk for warts.5

Damaging the skin increases the risk of warts.5,6 Thus, walking barefoot is a clear epidemiologic indicator of those who will contract plantar warts.

Another risk factor is having existing warts, which is a predictor of future warts.1 Transferring a virus to oneself is known as autoinoculation. Patients with warts should be advised not to bite, pick, or otherwise damage them, as doing so can release viral particles. These particles can implant on adjacent skin surfaces and may eventually cause crops of warts in a closely circumscribed area. Biting a wart can allow the virus to implant on the tongue, mucous membrane, or lips. Children should be instructed not to bite their fingernails or pick at hangnails, as both of these nervous habits can lead to skin breakage and increase the risk of warts. Shaving can spread an existing wart to new areas.6 For this reason, the face in men and the legs in women are common attack sites.5

Patients may ask the pharmacist where or how they contracted the virus. HPV can have a long latency period (perhaps 8 months or more), so it is usually impossible to identify the causal location or behavior.3 Infected patients may have touched a wart on another person.5 They may have contacted a fomite (i.e., an object that may be contaminated with infectious organisms), such as a towel that an infected person used to dry himself. They may have walked barefoot in an area where an infected person walked with bare feet, the most common means by which plantar warts are spread. In this case, pharmacists can help identify such common wart inoculation sites as swimming pools, gyms, and communal shower stalls. Patients may recall a specific skin break that allowed penetration, such as tattooing or skin piercing.

Types of Warts

Common Warts: Common warts (verruca vulgaris) constitute 70% of all warts.1 They seldom cause pain or discomfort, unless they arise in a part of the body where repeated environmental contact or unpleasant friction with clothing continually abrades them.7 They are most often found on the fingers, around the fingernails, and on the backs of the hands, although they can infect any part of the skin.8 They grow outward (a type of pattern known as exophytic), and the raised round or oval surface has a rough appearance, much like that of a cauliflower.1,7,8 The color is dark, light, or occasionally black.7 Patients often notice small black dots in the wart. These dots have the appearance of small seeds, leading to their being referred to as seed warts. Although patients believe that these “seeds” are the causative agents of additional warts, they are actually coagulated blood vessels.1

Plantar Warts: Plantar warts are usually located on the sole of the foot, an area also known as the plantar surface.1,8 Continual pressure caused by walking pushes the wart inward, so that plantar warts are referred to as endophytic (growing inward). The pressure of walking causes discomfort that may be mild (like a rock in the shoe) or intensely painful, hampering such normal activities as walking and running.7 These warts may also exhibit black spots on the surface. Patients may develop several plantar warts that are connected beneath the skin surface, a condition known as mosaic warts.

Flat Warts: As the name implies, flat warts are flush with the surface of the skin.1,8 While they can be found on any section of the skin, they prefer men’s beards, women’s legs, and children’s faces. They are smaller than common warts, and tend to implant in large crops of 100 or more. Flat warts are more common in children, and they are actually quite rare in adults.7

Filiform Warts: The distinguishing characteristic of filiform warts is implied in the name, which means “thread-shaped.” These warts develop extensions that can rapidly grow out into surrounding skin.1,8 Common sites include the perioral and periorbital areas and the nose.

Subungual and Periungual Warts: When the patient has warts on the hands or feet, they may spread to the areas around the fingernails or toenails. They can also grow underneath the nails. Those beneath the nails are extremely difficult to cure.7

Genital Warts: Genital warts, also known as condyloma acuminata, are located on the genitalia, pubic area, between the thighs, inside the vagina, or in the anal canal.7 They carry a high viral load, so that as many as 65% of a patient’s sexual contacts will also become infected.3 Genital warts can cause cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers.9,10

Spontaneous Regression

Untreated warts often disappear without any treatment, a phenomenon known as spontaneous regression. However, the patient cannot predict whether this will eventually occur, and waiting for it allows the wart to spread the virus to the patient and to others. Therefore, it is preferable to seek appropriate care to remove the wart(s).

Treatment Options

Nonprescription Medications: Nonprescription products are only safe and effective when treating common or plantar warts.1 Patients should not treat any other type of wart and should not apply wart products to birthmarks, moles, or unusual warts with hair growing from them. They should not treat warts on the face, mucous membranes, or genitals. Patients who wish to treat hand warts should be advised to keep the hands as dry as possible during treatment, as overhydration of the stratum corneum can facilitate viral release (with the exception of the suggested pretreatment soaking). Wart products should be avoided if the skin is irritated, infected, or erythematous. Patients with diabetes mellitus or poor circulation should not use them due to an increased risk of infection. The maximum time of use is 12 weeks. If the wart remains after this, the patient should be instructed to see a physician.

The only safe and effective nonprescription wart medication is salicylic acid.1,11 Preparations are available in gels or collodion-based liquids (5%-17% salicylic acid), patches (12%-40%), and a karaya gum/glycol patch (15%). Collodion-based liquids should not be used around fire or flame and must be tightly capped after use to prevent evaporation of the ether. If visible crystals appear in a bottle, it must be discarded. Patients should not inhale the vapors from collodion-based products. They should presoak the area for 5 minutes and dry it thoroughly before application of the product.

Salicylic acid is a keratolytic agent that slowly removes epidermal cells infected with HPV. The dosage forms also occlude the skin, and presoaking followed by occlusion aids the product’s action through maceration of the stratum corneum.

Liquids should be applied one or two times daily with the applicator. Patients may surround the wart with petrolatum to help prevent it from reaching healthy skin. Plasters/patches are cut to size, applied, and left on for 48 hours, after which a new one is applied.

Freezing Therapies: Physicians have long applied cryotherapy to cure warts. A typical regimen is liquid nitrogen at -196˚C (-321˚F) applied until the wart has a 2 mm white halo surrounding it.4 Some physicians continue this application until the halo has been present for 20 seconds. Pain and blistering are common.

Since 2003, manufacturers have marketed nonprescription products that purport to freeze warts off.1 These cryogenic wart removal systems are regulated as medical devices by the FDA.1 They include Compound W Freeze Off, Dr. Scholl’s Freeze Away, and Wartner.12 All contain dimethyl ether and propane, and the latter also lists isobutane. These products cannot reach the temperature achieved by liquid nitrogen, or they would be far too dangerous for OTC sales. They also carry numerous precautions to help ensure safe use, such as prohibiting use in children under the age of 4 years.1,12

Occlusion: Collodion-based products occlude the area, perhaps augmenting their efficacy. This has led to the widespread practice of placing duct tape over the wart. Despite positive reviews in the lay media, there is little evidence to support its efficacy.13

PATIENT INFORMATION

Which Warts Can Be Self-Treated?

Warts can appear anywhere on the body, although not all types should be self-treated. For example, you cannot self-treat warts on the face. Nonprescription wart products work by slowly eating into the area where they are applied. Eventually, they expose the wart and slowly destroy it. There is a slight chance that the skin might look abnormal after the wart is eradicated. If this were to occur on the face, it would be a permanent scar.

Similarly, you cannot self-treat warts on the mucous membranes, such as inside the nose or mouth. Wart products are only safely applied to the outer layer of dead skin, and mucous membrane is living tissue.

Finally, you must not self-treat warts of the genital area. They could be signs of a sexually transmitted disease and must be evaluated by a physician.

Be Sure It Is a Wart!

Before you try to treat a wart, you should be sure that it is not something else. Never apply wart products to birthmarks, as they could scar the skin. If the suspected wart has hair growing from its surface, it is best to seek medical advice, as warts typically do not exhibit hair growth. You should never try to remove a mole with wart products. Doing so could cause pain, bleeding, and scarring.

How Do You Use Nonprescription Products?

Legitimate nonprescription wart products all have salicylic acid as the active ingredient. You can choose from several dosage forms. Liquids are easy to use. You simply apply the liquid with the applicator supplied (usually a small brush) until the wart is covered. Make sure you do not get the product on healthy skin, as the salicylic acid will eat into healthy skin just as it does with the wart.

You may also choose a patch; these products are easy to use as well. Some are precut circles. You should first remove the adhesive, then center the patch over the wart, pressing it to ensure it adheres well. Other patches are small rectangles or squares that allow you to cut the size needed before pressing it over the wart.

Gels often come in plastic bottles that make it difficult to apply since you cannot see where the gel is in the squeeze bottle. You may accidentally apply too much. Ask your pharmacist if you have other questions.

How Long Does Treatment Take?

If your skin problem is really a wart, nonprescription wart products should begin to slowly eat it away. You should notice improvement within a week, and complete removal of the wart within a few weeks, although the exact time is dependent on the size of the wart, its location, and whether you apply the product exactly as directed.

You have a maximum time of 12 weeks to try to remove the wart on your own. After that time, you should see a physician. What you think is a wart could actually be a squamous cell skin cancer, melanoma, or any of several other conditions that require a physician’s intervention.

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Rashes Photos – See our Rashes Photo Library for additional informaion.
What Are Warts?
Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. The common wart is a small, hard, rough bump that usually occurs on the hands and fingers, but they can be flat and smooth. Warts vary in color (white, pink, or brown), and may contain tiny spots that look like black hairs or specks. The appearance of a wart depends on where it is growing. Warts can occur on any area of the body, but they are most common on the fingers, hands, arms, and feet.
What Causes Warts?
Warts are tiny skin infections caused by viruses of the human papillomavirus family. Most people have a wart at some time in their lives. Warts appear more commonly in children.
How Do You Get Warts?
The viruses that cause warts are passed from person to person by close physical contact. Even a tiny cut or scratch or a lengthy immersion in water, such as competitive swimming with a person who has warts, can make the skin more vulnerable to warts.
The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is present. The causative virus thrives in warm, moist environments, making infection a common occurrence in swimming facilities.
How Do You Get Warts?
Warts are passed from person to person, sometimes indirectly. The time from the first contact to the time the warts have grown large enough to be seen is often several months. The risk of catching hand, foot, or flat warts from another person is small.
Why Do Some People Get Warts And Others Don’t?
Some people get warts depending on how often they are exposed to the virus. Wart viruses occur more easily if the skin has been damaged in some way, which explains the high frequency of warts in children who bite their nails or pick at hangnails. Some people are just more likely to catch the wart virus than are others, just as some people catch colds very easily. Patients with a weakened immune system also are more prone to a wart virus infection.
How Many Kinds Of Warts Are There?
There are several different kinds of warts including:
. Common warts
. Foot (Plantar) warts
. Flat warts
Common warts – usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked. These are often called “seed” warts because the blood vessels to the wart produce black dots that look like seeds.
Foot warts – are usually on the soles (plantar area) of the feet and are called plantar warts. They are often mistaken for corns or calluses—which are layers of dead skin that build up to protect an area which is being continuously irritated. You can tell the difference because plantar warts disrupt the natural lines of the skin and may have small black dots on their surface, which are tiny blood clots in blood vessels. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin.
Flat wartsare smaller and smoother than other warts. They tend to grow in large numbers – 20 to 100 at any one time. They can occur anywhere, but in children they are most common on the face. In adults they are often found in the beard area in men and on the legs in women. Irritation from shaving probably accounts for this.
Do Warts Need To Be Treated?
Warts usually don’t cause any symptoms and do not require treatment, although plantar warts may be painful. In children, warts can disappear without treatment over a period of several months to years. However, warts that are bothersome, painful, or rapidly multiplying should be treated. Warts in adults often do not disappear as easily or as quickly as they do in children. Although there is no specific cure for warts and most will disappear on their own in a few years, if the warts are painful or causing cosmetic problems, treatment should be considered.
Common warts: In young children, these warts can be treated at home by parents on a daily basis by applying salicylic acid gel, solution or plaster (over the counter). There is usually little discomfort, but it can take weeks of treatment to get rid of the wart. Treatment should be stopped at least temporarily if the wart becomes sore.
Foot warts: Plantar warts are more difficult to treat because the bulk of the wart lies below the skin surface. . It is important to soften the warts by soaking them in warm water and then paring them down with an emory board or pumice stone and then apply an over the counter medicine with salicylic acid. Persistent or very painful plantar warts may need to be surgically removed. Other recommendations include a change in footwear to reduce pressure on the wart and keeping the foot dry since moisture tends to allow warts to spread.
Flat warts: These wartsare often too numerous to treat with methods mentioned above. As a result, “peeling” methods using daily applications of salicylic acid is recommended. For some adults, periodic office treatments for surgical treatments are sometimes necessary.
Salicylic Acid: Most Common Over The Counter (OTC) Treatment

  • Salicylic acid softens the skin layers that form the wart so that they can be rubbed off.
  • Repeated irritation to the wart may also trigger an immune system response that can help destroy the wart.
  • Soaking in warm water prior to applying medicine will softer the wart and allow the medicine to better penetrate the wart.

Examples of common OTC brands:
. Trans-Ver-Sal
. Compound W
. Dr. Scholl’s
. Occlusal
. Duofilm
. Duoplant
Directions for wart pads:

  1. Wash affected area. Must soak wart in warm water for 5 minutes.
  2. Dry area thoroughly.
  3. Apply medicated disc. If necessary, cut disc to fit wart. Repeat procedure every 48 hours as needed (until wart is removed) for up to 12 weeks.
  4. Note: Self-adhesive comfort cushions may be used to conceal medicated disc and wart.

Directions for applying gels:

  1. Wash affected area. Must soak wart in warm water for 5 minutes.
  2. Dry area thoroughly.
  3. By squeezing the tube gently, apply one drop at a time to sufficiently cover each wart. Let dry.
  4. Repeat procedure once or twice daily as needed (until wart is removed) for up to 12 weeks.

Salicylic acid may damage healthy skin surrounding the wart. To avoid damaging other skin, cover the surrounding skin with a doughnut-shaped pad or bandage when applying salicylic acid.
Do Not Use Salicylic Acid On:

  • irritated skin
  • any area that is infected or reddened
  • moles
  • birthmarks
  • warts with hair growing from them
  • genital warts
  • warts on the face
  • warts on mucous membranes, such as inside mouth, nose, anus, genitals, lips.

Duct Tape: Is This A Recommended Home Treatment?
The newest treatment recommendations are to cover the warts with duct tape for 6 out of 7 days at a time. You then soak and pare down (use an emory board) the wart and then reapply the duct tape the next morning. In one recent study, this treatment worked 80% of the time after about two months, while freezing worked less than 60% of the time.
How Do Dermatologists Treat Warts?
Dermatologists are trained to use a variety of treatments, depending on the age of the patient and the type of wart.

  • Cantharidin: Warts may be treated by “painting” with cantharidin in the dermatologist’s office. Cantharidin causes a blister to form under the wart. The dermatologist can then clip away the dead part of the wart in the blister roof in a week or so.
  • Cryotherapy: For adults and older children cryotherapy (freezing) is generally preferred. This treatment is not too painful and rarely results in scarring. However, repeat treatments at one to three week intervals are often necessary.
  • Electrosurgery : Electrosurgery (burning) is another good alternative treatment.
  • Laser: Laser treatment can also be used for resistant warts that have not responded to other therapies. Laser therapy is used to destroy some types of warts. Lasers are more expensive and require the injection of a local anesthesia to numb the area treated.
  • Aldara (imiquimod) is a newer, non-destructive treatment for warts. It is a cream that was first used to treat anogenital warts, but is now being used more to treat other types of warts and molluscum contagiosum. It is applied to the warts three times a week, either with or without an occlusive dressing (bandaid). You might need to soak and then pare or trim down the wart and then apply Aldara for it to work best.

What About The Problem Of Recurrent Warts?
Sometimes it seems as if new warts appear as fast as old ones go away. This may happen because the old warts have shed virus into the surrounding skin before they were treated. In reality new “baby” warts are growing up around the original “mother” warts. The best way to limit this is to treat new warts as quickly as they develop so they have little time to shed virus into nearby skin. A check by your dermatologist can help assure the treated wart has resolved completely.

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THERE are many different types of lumps and bumps that appear on our skin.

In most cases they’re harmless, but some can be warning signs that something more sinister is going on – from cancer to liver problems.

7 It is important to know which skin lumps are dangerous so you know when to see a GPCredit: Getty Images

For this reason it’s really important to know what to look out for so you can work out whether you need to seek medical advice.

Here are six common types of skin blemishes that you should be aware of.

1. Papules

Papules are one of the most common types of bumps that appear on the skin and are a type of pimple, according to Medical News Today.

But unlike the usual pimples with pustules, they don’t have a yellowish, liquid blister of pus and are, instead, solid to touch.

7 Papules are like pimples, but are hard to touch and do not have a pus filled topCredit: Head & Face Medicine

They appear when the skin’s pores become so blocked with dead skin cells, oil and bacteria that they break.

Papules are usually small, only growing to be about the width of a fingernail.

It may have a dome shape or it may have a flattened top, and it may even have a small impression in the middle that looks like a navel.

They can be treated with over-the-counter medicines and, if these do not work, a GP can prescribe medication.

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2. Skin tags

7 Skin tags grow due to excess collagen but are harmless and considered more of a cosmetic problemCredit: NHS

Skin tags are small, soft, skin-coloured growths that hang off the skin and look a bit like warts.

They are quite common and harmless and are usually found on the neck, armpits, around the groin or under breasts.

Also known as acrochordons, they can also develop on the eyelids or under the folds of the bottom.

Skin tags are made of loose collagen fibres and blood vessels surrounded by skin.

They are more common in older people and often develop after weight gain or pregnancy.

They are considered more of a cosmetic concern rather than a medical problem.

3. Basal cell carcinoma

7 Basal cell carcinoma is is a type of non-melanoma skin cancer that develops in the outer most layer of skinCredit: Getty Images

The most common type of skin cancer is basal cell carcinoma.

It is a type of non-melanoma skin cancer that develops in the outermost layer of skin.

More than 100,000 new cases of non-melanoma skin cancer are diagnosed in the UK each year, according to the NHS.

Basal cell carcinoma is usually caused by intense sun exposure, affects more men than women and is more common in the elderly.

It will rarely spread beyond the original tumour site, but if left untreated may cause damage to the nerves and muscles.

4. Melanoma

7 Melanoma is the most serious type of skin cancer and can affect the lymph nodes and blood vesselsCredit: Getty Images

This is the most serious type of skin cancer and can affect any area of the body’s skin.

It grows so deep in the skin it can affect the lymph nodes and blood vessels.

The most common warning sign of a melanoma is the appearance of a new mole or a change in an existing mole.

This can occur anywhere on the body, but the most commonly affected areas are the back in men and the legs in women.

There were more than 15,000 new cases of melanoma in the UK in 2014, according to Cancer Research UK.

Depending on the stage of the cancer, the survival rates are different.

Most people will survive a stage one melanoma, but by stage four the survival rate drops to 10 per cent in men and 25 per cent in women.

5. Actinic keratosis

7 Actinic keratosis usually appears as dry, scaly patches and if left untreated can lead to cancerCredit: Getty Images

Ultraviolet light, from any type of sun exposure, can cause actinic keratosis.

The condition usually shows itself as dry, scaly patches caused by years of sun exposure.

The patches can be pink, red or brown in colour, and can vary in size from a few millimetres to a few centimetres across.

They most commonly appear on the face, especially the nose and forehead, forearms and back of the hands, on bald scalps or on the legs.

The patches are usually harmless and sometimes disappear on their own, but they are considered a pre-cancer because they can develop into a carcinoma if left untreated.

6. Hemangiomas

7 A hemangioma can occur anywhere on the body and is caused by a cluster of blood vesselsCredit: The Mayo Clinic

Hemangiomas are a type of noncancerous tumour that can grow on the skin due to an abnormal collection of blood vessels.

They are most commonly a birthmark that appears as a rubbery, bright red nodules.

A hemangioma can occur anywhere on the body, but most commonly appears on the face, scalp, chest or back.

If someone has multiple hemangiomas on their skin, they are at increased risk for also having an internal hemangioma, most often, the liver.

  • If you are ever worried about a lump or bump on your skin, you should speak to your doctor for professional advice

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Bumps & Benign Skin Growths

What Are Bumps & Benign Skin Growths?

Your skin is your body’s largest organ, a shield against heat, light, harmful bacteria, water loss, injuries and environmental hazards. Regardless of its ability to act as armor, it is still subject to a variety of bumps and benign (non-cancerous) growths.

Common skin conditions include keloids, keratosis pilaris, folliculitis, boils, carbuncles and skin tags. It’s important to recognize marks on your skin and visit a dermatologist if you notice a new or suspicious bump or lesion.

Symptoms

Benign skin growth symptoms vary depending on the condition.

  • Keloid – This is a smooth, hardened scar that rises above the skin and spreads.

  • Keratosis pilaris – These small, scaly bumps usually appear on the upper arms, thighs and buttocks.

  • Folliculitis – These inflamed hair follicles are due to a bacterial or fungal infection. Clusters of small red bumps or white-headed pimples appear. Skin can itch or burn and feel tender or painful. Pus-filled blisters break open and become crusty.

  • Boils – These are red, tender bumps filled with pus that grow larger and more painful until they burst and drain. They usually appear on the face, neck, thighs, buttocks or armpits.

  • Carbuncle – This is a cluster of boils that causes a more serious skin infection and may induce fever and chills.

  • Skin tags – These are soft, skin-colored growths connected to the skin’s surface by a piece of tissue called a stalk. They typically appear on the neck, armpits, torso, beneath the breasts or in the genital area.

Dermatologists treat bumps and benign skin growth using a variety of methods.

  • Surgery – Dermatologists can surgically remove keloids and skin tags. They can also open and drain boils and carbuncles.

  • Topical creams – Moisturizers containing a retinoid, urea, lactic acid, glycolic acid, salicylic acid or alpha hydroxy acid can help smooth the appearance of keratosis pilaris. Antibiotic creams and gels fight the infections caused by boils, carbuncles and folliculitis.

  • Oral medications – Antibiotics fight severe or recurrent skin infections.

  • Cryotherapy – Dermatologists can freeze warts using liquid nitrogen. The warts fall off in two to four weeks.

Ready for an Appointment?

If you’re experiencing signs or symptoms of bumps & benign skin growths, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat bumps & benign skin growths.

An Unusual Granular Cell Tumour of the Buttock and a Review of Granular Cell Tumours

Abstract

Granular cell tumours, first described by Abrikossoff in 1926, are known to occur in skin, connective tissue, breast, gastrointestinal and genital tracts. While they are rare, they are more common in people of African descent and show a slight female preponderance, usually presenting as solitary and painless masses. Less than 10% of occurrences are multiple, and fewer than 3% of tumours behave in a malignant fashion. The mean age, at presentation, is 40–60 years. We report a case of granular cell tumour in a young white male presenting with a painful soft tissue tumour in his buttock. The presentation is unusual because of the age, patient demographic, body site, and clinical presentation. The clinical and histological aspects are reviewed in the context of this clinical case and the associated literature.

1. Background

Granular cell tumours were first described by Abrikossoff in 1926 and are known to occur in skin, connective tissue, breast tissue, and gastrointestinal and genital tracts—with the head and neck being the most common regions. The tongue is the most common site in the head and neck . Granular cell tumours are rare; some authors have suggested that they make up around 0.5% of all soft tissue tumours . Frequent locations are the tongue (40%), breast (15%), respiratory tract (10%), and oesophagus (2%) . The tumours can be multicentric (5% to 14% of cases) . These tumours have a higher incidence amongst women and a greater prevalence amongst people of African descent. There has been one case report of a mother and son, both of whom presented in childhood with multiple granular cell tumours . While the origins of granular cell tumours are often debated, Abrikossoff originally postulated a myogenic origin and termed this a “myoblastoma.” These tumours are now considered to be neoplasms of neural origin, as evidenced by immunohistochemical studies . Diffuse S-100 positivity is present in nearly every case. S-100 is a calcium binding protein expressed in nerve tissue, melanocytes, adipocytes, and myoepithelial cells. Dermal nonneural granular cell tumours may be a different entity . It is difficult to make a diagnosis of malignancy in these tumours based on the histological appearance. Tumours that do metastasize tend to show cellular pleomorphism, mitotic activity, and spindling. Size greater than 5 cm, rapid growth rate, or invasion of adjacent structures is more likely to suggest malignancy . Most granular cell tumours are benign, with a self-limiting growth pattern. When they metastasize, the most common sites are regional lymph nodes, lungs, or bones . Granular cell tumours are rare on the trunk and usually present as a solitary, painless mass, with the patient usually noticing a lump .

The case we are reporting is that of a young white male, aged 27, who presented with a two-month history of a 2 cm mass in his buttock, which was preventing him from sitting down, due to pain. Our initial clinical impression of this fibrofatty mass was of a well-circumscribed lipoma or neurofibroma, and the differential diagnosis included a cyst. The pain and tenderness to touch were attributed to pressure effects on his sciatic nerve. Given that this was a young male patient presenting with a painful dermal/subcutaneous mass, we did not consider granular cell tumour as part of our differential diagnosis until histopathological examination.

2. Case History

A 27-year-old white male was referred to our centre, by his GP, with a lump in the patient’s right buttock. The mass was 2 cm in diameter and was felt to be a lipoma clinically. The patient himself was not aware of the lump and had visited his GP only because every time he sat down he felt pain over his buttock region, which radiated down his leg. This symptom was easily reproducible and prevented the patient from sitting down on hard surfaces. The patient was otherwise well, with no other medical conditions. There was no family history of any malignancy or cutaneous masses or lipomata.

On examination, we felt a well-localized, approximately 2 cm soft tissue mass, which was clinically located in the deep dermis or in the subcutaneous fat. There was no attachment to muscle and no overlying skin changes. Our differential diagnoses included lipoma, neurofibroma, or cyst. Given that the lesion was well localized, not greater than 2 cm and not adherent to muscle or deep fascia, we proceeded to excise the lesion under local anaesthesia, without imaging.

During the operation, the lesion seemed well localized and intraoperatively resembled a sebaceous cyst or pilomatrixoma.

Histological reports are detailed below. A compete skin and lymph node examination revealed no other abnormalities. After reviewing the histopathology, this patient was managed with a wide local excision with 1 cm margins.

3. Histopathological Examination

The tumour was well circumscribed, spanned the entire dermis, and showed broad interface with the underlying adipose tissue. The interface with the epidermis was quite irregular, with prominent epidermal pseudoepitheliomatous hyperplasia (Figures 1 and 2).


Figure 1
H&E, 20x magnification.

Figure 2
H&E, 100x magnification.

Histologically, the tumour cells were quite monomorphous, with small round nuclei and abundant granular eosinophilic cytoplasm (Figure 3). The tumour cells were diffusely positive with S-100 immunohistochemical stain. There were no features of malignancy, such as nuclear pleomorphism, necrosis, spindling, or mitotic activity.


Figure 3
H&E, 400x magnification.

4. Discussion

Granular cell tumours are uncommon and when they occur, they are most common in the head and neck. They present as painless masses. Surgical excision is the treatment of choice. The recurrence rate for granular cell tumours has been reported at 2%, when local wide excision has been undertaken . Most granular cell tumours can be easily managed by wide local excision; in cosmetically sensitive areas, where tissue preservation is paramount, Mohs Micrographic Surgery has been used .

Histologically the tumour presented no diagnostic difficulty. However if the tumour was sampled superficially, the irregular interface with the overlying epidermis would create a well-known diagnostic pitfall. With superficial biopsy, one can see how easily a diagnosis of invasive, well-differentiated, squamous cell carcinoma can be made. This can lead to a potentially harmful, unnecessary surgery, especially when the lesion is present in the tongue.

Our patient presentation was unusual, given that it was the symptomatic nature of the lesion that led to the diagnosis—with the patient being unable to sit due to buttock pain—which resulted in the initial referral; the impression, prior to surgery, of a neuroma; during surgery, a cyst or pilomatrixoma. A survey of buttock tumours had suggested that when pain is present it is usually due to cyst formation in an old haematoma, and pain along the course of the sciatic nerve, and its branches, was present in 40 percent of the cases .

Malignant behaviour is rare and is seen in up to 2% of the cases. Most of the malignant tumours arise in the thigh, while malignant granular cell tumours of the head and neck are very rare . The malignant granular cell tumours are more common in African American women. Age of the patients with malignant tumours is the same as for benign cases, that is, 30–50 years. The treatment of choice is complete wide local excision, as was performed on our patient. There are no clinical or histopathologic features to suggest that the tumour we present will behave in a malignant fashion.

The tumour we present was excised completely, as incomplete excision may produce recurrences in 21–50% of the cases .

This case report suggests that granular cell tumours must be considered in the differential diagnosis of painful buttock tumours.

Conflict of Interests

The authors have indicated no commercial interests.

Molluscum Contagiosum

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Although molluscum contagiosum is a common skin rash in kids, many parents have never heard of it. The most important thing to know is that for most children, the rash is no big deal and goes away on its own over time.

About Molluscum Contagiosum

Molluscum contagiosum is a viral infection that causes a mild skin rash. The rash looks like one or more small growths or wart-like bumps (called mollusca) that are usually pink, white, or skin-colored. The bumps are usually smooth and shiny or pearly-looking, and may have an indented center.

Infection is most common among kids between 1 and 12 years old, but also affects:

  • athletes who have close skin-to-skin contact, such as wrestlers, or athletes who share equipment, such as gymnasts
  • people whose immune systems have been weakened by conditions such as HIV, cancer treatment, or long-term steroid use

As you might guess by its name, this skin disorder is contagious, and can be passed from one person to another. It is unknown how long the rash and virus might be contagious.

Causes

Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), a member of the poxvirus family. This virus thrives in warm, humid climates and in areas where people live in close quarters.

Infection with MCV happens when the virus enters a small break in the skin’s surface. Many people who come in contact with the virus have immunity against it, and do not develop any growths. For those not resistant to it, growths usually appear 2 to 7 weeks after infection.

Kids can get molluscum contagiosum in a few different ways. It spreads easily, and most commonly, through direct skin-to-skin contact, but kids can get it by touching objects that have the virus on them, such as toys, clothing, towels, and bedding.

Once someone has molluscum contagiosum, it can be spread from one part of the body to another by scratching or rubbing the bumps and then touching another part of the body.

Molluscum contagiosum also can be spread between sexual partners.

Signs and Symptoms

Because it is a skin infection, the only real sign or symptom of molluscum contagiosum are the small round pink, white, or skin-colored mollusca on the skin. These bumps are filled with a white, waxy core that contains the virus, and might have a shiny or “pearly” look.

Each molluscum starts out as a very small spot about the size of a pinhead and grows over several weeks into a larger bump that might become as large as a pea or pencil eraser. A tiny dimple (indentation) often develops on the top of each molluscum.

The mollusca can appear alone as a single bump or in groups, clusters, or rows. They can show up almost anywhere on the skin, but in kids are most commonly found on the chest, stomach, arms (including the armpits), legs, groin, genital area, and face.

In sexually active teens and adults, the bumps are usually located in the genital area or the inner thighs. Rarely, the bumps can happen around the eyes or around the mouth.

Most people develop between 1 and 20 mollusca. They’re usually painless, but can become itchy, red, swollen, sore, and infected, especially if scratched.

Diagnosis

A doctor is likely to recognize molluscum contagiosum just by looking at the rash. The doctor might refer you to a dermatologist, a doctor who specializes in skin diseases.

Treatment

In many cases, molluscum contagiosum is left to go away on its own without treatment. Each individual molluscum typically disappears in about 2-3 months. However, new growths generally appear as old ones are going away, so it usually takes 6-18 months (and can take as long as 4 years) for molluscum contagiosum to go away completely.

Sometimes, doctors use treatments to remove the growths or help them go away more quickly, such as:

  • removing the contagious center by squeezing the bumps with a scalpel or tweezers
  • removing growths by freezing them (cryotherapy) or scraping them off with a sharp instrument (curettage)
  • applying a chemical agent or cream, such as salicylic acid, tretinoin, cantharidin, or other wart medicine
  • giving a medicine by mouth called cimetidine

Although these treatments can sometimes help the disease resolve more quickly, many doctors do not use them on kids because they can be painful and burn, blister, discolor, or scar the skin. The use of treatment sometimes depends on the location and number of lesions. Some people request it if the rash is embarrassing or causes other problems, such as itching or other discomfort.

Treatment works best when started early because there are usually only a few growths. Your child’s doctor will talk with you about the advantages and disadvantages of treatment and help you decide whether treatment is necessary. Be sure to talk with the doctor before trying any at-home remedies, including removing the bumps yourself.

Complications

Molluscum contagiosum generally causes no long-term problems, and the growths usually leave no marks. However, treatments might scar the skin, and some people develop a secondary infection, which can be treated with antibiotics.

People with weakened immune systems can sometimes get a more serious form of molluscum contagiosum. They typically have more mollusca, especially on the face. The growths are larger, look different, and usually are more difficult to treat. In these cases, doctors might prescribe medicines that help strengthen the immune system.

Preventing the Spread of Molluscum Contagiosum

Because molluscum contagiosum is contagious and can spread to other parts of the body, someone who’s infected should follow these precautions:

  • Do not touch, scratch, or rub growths.
  • Wash hands often with soap and water.
  • Keep areas with growths clean.
  • Try to cover each growth with clothing or a watertight bandage, especially before participating in activities in which equipment is shared or skin contact can occur, like swimming and wrestling.
  • Change each bandage daily or when it becomes dirty.
  • Do not shave over areas that have bumps.
  • Moisturize the skin if dry.

As long as they follow these precautions until all of the bumps are gone, kids with molluscum contagiosum can still go to school or daycare, participate in sports, and play with other children. They can even go swimming in public swimming pools, as long as they keep their towels and water toys to themselves.

A person can get molluscum contagiosum again through contact with someone who’s infected, but this is rare.

To avoid infection, have your kids follow these tips:

  • Wash hands often with soap and water.
  • Do not share towels, clothing, and other personal items.
  • Do not share kickboards and other water toys at swimming facilities.
  • Do not touch or scratch bumps or blisters on your skin or other people’s skin.

Reviewed by: Patrice Hyde, MD Date reviewed: July 2016

Let’s face it: moles, skin tags, and warts are irritating. Plus, they can be confusing. Most people just don’t know the difference between them.

The good news: none of them cause a risk to your health. But they’re annoying, and it makes your life more comfortable to get rid of them before they become a problem. So, if you want to know what you’re dealing with before you schedule a spot removal, here’s how to tell the difference between a mole, a wart, and a skin tag.

Skin Tags

This little flap of skin forms because of friction. It’s been rubbed by a collar, clothing, or sometimes it comes from skin rubbing against skin, particularly under the arm. It starts as a small bump or gland in the skin. Then, once it starts rubbing, there’s a snowball effect. The little ball of skin cells gets pulled up further and further until it’s hanging by a thread. You end up with a ball of skin attached by a thin pedestal.

What Do Skin Tags Look Like?

Skin tags are small flaps of skin, ranging from the size of a small pen head to three centimeters. They form when a small bump or gland sticks up from the skin. That bump is then rubbed, typically under the arms, in the groin, or around the neck. Because of friction, the flap rises even more and can form into a ball shape.

Should You Have A Skin Tag Removed?

The biggest problem with skin tags is the irritation they cause. They can snag, bleed, and hurt. In general, they are just bothersome.

Although they are not dangerous, when skin tags become painful, tender, or unsightly, many patients ask to get them removed.

Skin Tag vs. Wart

Distinguishing a skin tag vs wart is rather simple. A colorless raised flap of skin that looks like a little balloon on a stick is a skin tag. A rough, broad-based patch of thick skin is likely a wart.

Neither of these spots have hair growing from them. Like skin tags, warts are typically colorless, unless the skin where it’s formed has a color distinction. Warts are thick and deep, while skin tags remain at the surface.

Most importantly, a wart is caused by a virus and is contagious. It can spread to other people, or to other parts of your body. Skin tags are not contagious to you or anyone else.

Warts

Warts pop up on your hands, knees, or the bottom of your feet. Unlike moles, they’re hard bumps that lie deep in the skin. Although they may be smooth on top, they’re thick, scaly, and callus-like underneath.

What Causes Warts?

Warts start from a virus. And like all viruses, they’re contagious. So, when you see a wart pop up, that means you came into contact with someone else with a wart virus, whether through shaking hands or using the same hand towel.

Should You Have A Wart Removed?

Although we recommend removing any of these spots, warts especially need to be removed quickly (before you pass the virus along to someone else). But when people try to treat them at home, they never seem to get better. Why? They’re a virus that lives in the skin cells. If you don’t get rid of the virus, you won’t get rid of the wart. So you have to treat it long enough to kill all the skin cells that contain the virus.

Wart treatments are painful. If people start an over-the-counter treatment, they often second-guess themselves when the area starts to hurt. They realize they don’t know what they’re doing, and they can’t stand the pain. So they stop the treatment too soon for it to be effective.

For the fastest wart treatment, ask your dermatologist to freeze the wart. This kills the cells containing the virus so your skin can heal wart-free.

Mole vs. Wart

Identifying a mole vs wart is also relatively easy. The main distinction is color. While warts are colorless, moles are brown. These dark spots grow slowly and don’t change much, but they can grow hair. Moles typically appear in sun-exposed areas such as the arms, face, back, and chest and are not contagious.

Both warts and moles have a broad base and go deep into the skin, but on a mole, the skin remains soft. Warts, however, appear as rough skin, possibly with points on the surface. They often appear on the hands, feet, elbows, and knees — where the skin is thicker and grows more slowly.

Moles are the most serious of these three skin issues. They form slowly, taking a long time to grow. If they become cancerous, they begin to change.

What Do Moles Look Like?

To see a visual difference between wart and mole bumps, look for pigment and hair. Warts don’t have either, but moles have both. Because of their pigment, they have the rare potential to change from a regular mole into skin cancer.

Some people are predisposed to develop moles, and sun exposure stimulates them. So, if you notice these small benign growths pop up easily on your skin, take extra precautions in the sun to prevent more from forming.

Moles & Warts vs. Skin Cancer

None of these skin issues are dangerous to begin with, but they can become dangerous if certain changes start to happen. Here are the early warning signs that your mole, bump, or wart is developing into something more serious.

Atypical Moles

Normal moles are either brown or tan — not multi-colored. If your mole seems to be various colors — brown, tan, black, and even red — that’s an early warning sign it’s developing into something else.

Moles are also generally round in shape. If your spot is asymmetrical and continues to increase in size, it may be skin cancer.

Moles can be either flat or raised — but they don’t typically change unless they’re dangerous. If a spot changes from flat to raised, that’s a warning sign.

Any time a mole seems to change or become irregularly colored, visit your dermatologist. Sometimes it’s hard to tell whether or not a spot is dangerous. It’s always best to let a professional make that determination. If you’re dealing with an atypical mole, they’ll likely remove it and send it off for testing.

Elevated Bump or Wart-Like Growth

Bumps, blisters, and warts are common. Usually, there’s nothing to fear. However, heed the warning if a spot doesn’t disappear within six weeks. Certain skin cancers can look like a wart or blister, and most are easily treated if you catch them early.

Wart/Sore That Bleeds or Won’t Heal

Pay attention to any wart or sore that doesn’t seem to heal. If it starts to bleed, that’s another sign it could be problematic. If you have a new growth or sore that isn’t healing, visit your dermatologist to have it professionally examined.

Know the ABCs of Melanoma

If you have an atypical mole or another spot that looks suspicious, remember “ABCDE” to check for early features that indicate melanoma.

  • Asymmetry: If you drew a line down the middle, the sides would not match.
  • Border: The edges of the spot are ragged, notched, or blurred. The pigment appears to fade into the skin.
  • Color: The color is not uniform. The spot contains shades of black, brown, and tan (and maybe white, gray, red, pink, or blue).
  • Diameter: Melanoma can range in size, but most are larger than six millimeters in diameter.
  • Evolving: Look for changes in the spot over several weeks or months.

Should You Try DIY Wart Removal or Mole Removal Treatments?

It can be tempting to try to remove these growths yourself. It’s probably bothering you, but maybe you don’t have time to see a professional. Your skin tag, mole, or wart isn’t dangerous — yet you can cause an infection if you try to remove it on your own.

More often than not, people aren’t successful with DIY spot removal treatments. So save yourself the frustration, and let a dermatologist take care of it.

Will Skin Tags, Moles, and Warts Go Away on Their Own?

No, these spots do not go away on their own. So, whether you have a mole, wart, or skin tag, a board-certified dermatologist can give you the most accurate identification and help you decide if the growth should be removed.

If you have a problematic spot on your skin, contact us to schedule a consultation and discuss your wart or mole removal options.

Dr. R. Todd Plott is a board-certified dermatologist in Coppell, Keller, and Saginaw, TX. His specialization and professional interests include treating patients suffering with acne, identifying and solving complex skin conditions such as psoriasis, rosacea, atopic dermatitis, and identifying and treating all types of skin cancers. In his spare time, Dr. Plott enjoys cycling, traveling with his wife, and spending time with his children and new grandson.

Learn more about Dr. Plott.

Book an appointment with a provider nearby.

9 Types Of Genital Warts & Other Bumps, Decoded

8. Angiomas

What They Look Like: Small clusters of red and/or purple blood vessels in a lump, looking a bit like a cherry.

What They Mean: Angiomas are small skin growths with broken blood vessels that can look highly alarming on first glance. However, they’re entirely benign. They don’t usually occur on the vulva or vagina, but it’s not a bad sign if they do, and it’s entirely your choice to have them removed, which is done via freezing, excision, or shaving off.

9. Vulval Cancer

What They Look Like: A lump, open sore, or bleeding mole, possibly accompanied by persistent itching, dark and raised patches of skin, bleeding discharge, and pain or tenderness.

What They Mean: Before you freak out, vulval cancer is exceptionally rare. In the UK, doctors only see new cases on average once every seven years, roughly 3.7 out of every 100,000 women. It’s far more likely that a lump is due to other causes, so your first step shouldn’t be to leap to worst-case scenarios. Vulval cancer is often treated using surgery, plus radiotherapy and chemotherapy, and it is serious, so if you have doubts, please get yourself checked out immediately.

Images: , Giphy

5. Genital warts

Of the more than 150 strains of HPV, about 40 occur below the belt, according to NYU Langone Health. Two strains in particular — number 6 and number 11 — cause about 90 percent of genital warts.

“You can find these benign warts in the vagina, the cervix, around the vulva, and in the anus,” explains Millheiser. They can also appear in the mouth and throat if spread through skin-to-skin contact. Certain strains of HPV can cause cancer, which is why getting any below-the-belt bumps checked out is so important. “There are cancerous lesions that may start as a small wart and then spread,” says Millheiser.

Why do I get them?

Long story, short: “We aren’t sure why some people get warts and others don’t,” says Jhin. While it’s not an exact science, are three main risk factors that likely play into your wart risk.

First, your immune system. Since warts are caused by a virus, having a compromised immune system (whether from an inherited condition, medication, or disease like cancer) can make you more susceptible. “There’s no question that people who are immune-compromised will be at risk for all types of infections including warts,” says Brodell. This is likely why kids tend to get warts more often than adults. “Most adults have probably already had warts and developed a specific immunity to them,” Brodell explains.

Most adults have probably already had warts and developed a specific immunity to them.

Breaks in your body’s natural barrier can also make you more likely to get warts. “If someone for instance has dry, cracked skin, it makes sense that it might be easier for the virus to take hold if someone is exposed,” explains Brodell. For that reason, people with skin conditions like eczema might also be partially vulnerable to warts. Finally, there may also be a genetic component, Jhin adds.

But no matter how susceptible you are to warts, you can’t get them without being exposed, which happens through skin-to-skin exposure. “It could be sexual exposure, shaking hands with someone with warts on their hands, even walking on the floor after someone walked by and left a little piece of the virus behind,” explains Brodell. Anytime you come into direct contact with the presence of HPV anywhere on the body, it’s a risk.

Getty ImagesHow do I treat them?

While there’s no cure for HPV (and therefore no way to “cure” your wart), treating them is relatively simple in most cases. “For common warts on the hands and feet, the most common treatment is liquid nitrogen cryotherapy,” says Brodell. “That’s when a doctor sprays the liquid nitrogen on the wart, which freezes it to 192 degrees below zero — it kind of stings and burns and the top of the wart dies, tends to crust up, and finally falls off.”

How Are Warts Treated?

In most cases, warts found on the skin are harmless and can disappear without treatment. However, genital warts should be evaluated by a doctor.

Sometimes, warts may recur after treatment and more than one type of treatment may be necessary. Although practitioners attempt to clear warts quickly, most methods require multiple treatments. Treatments may include:

  • Freezing (Cryotherapy): can be done with over-the-counter freezing spray products or by your doctor, who will use liquid nitrogen to freeze a wart. For the at home treatment, temperatures can reach as low as a negative 100 degrees. The down side of this home treatment is that it may not freeze the wart deep enough to be effective. It can also be painful because the spray needs to be applied longer than if you were being treated in a doctor’s office. When it works, a blister forms around the wart and the dead tissue falls off within one to two weeks.
  • Cantharidin: This substance, an extract of a blister beetle and applied to the skin, forms a blister around the wart. After cantharidin is applied, the area is covered with a bandage. The blister lifts the wart off the skin.
  • Other medications: These include bleomycin, which is injected into a wart to kill a virus, and imiquimod (Aldara and Zyclara), an immunotherapy drug that stimulates your own immune system to fight off the wart virus. It comes in the form of a prescription cream. Although imiquimod is stated for genital warts, it is modestly effective on other types of warts.
  • Salicylic acid: Over-the-counter wart treatments come in several forms (gel, ointments or pads) and contain salicylic acid as the active ingredient. When applied on a regular basis, the acid gradually dissolves the wart tissue. The process may take several weeks.
  • Minor surgery: When warts cannot be removed by other therapies, surgery may be used to cut away the wart. The base of the wart will be destroyed using an electric needle or by cryosurgery (deep freezing).
  • Laser surgery: This procedure utilizes an intense beam of light (laser) to burn and destroy wart tissue.
  • Over- the-counter medication: Usually this contains salicylic acid and is applied in gel, ointment or lotion form. Applied regularly, the wart eventually peels off. This is not for use in genital warts.

Moles and Warts

What are warts?

Warts are skin growths that are caused by a type of virus called the human papillomavirus or HPV. There are more than a hundred types of HPV known to infect the skin, usually through an area of broken skin. HPV causes the top layer of skin to grow rapidly and this is what forms the wart. Warts can grow anywhere on the patient’s body and are most common among children and young adults. They usually go away on their own within months or years, but may need professional treatment when they start to spread or become painful.

What are the different types of warts?

Common warts are those that are most often seen on the hands and may also grow on other parts of the body. They are dome-shaped, rough, and grayish-brown in color.

Plantar warts are those that grow on the soles of the feet. They are thick, hard patches of skin that cause pain when the patient walks, much like stepping on a piece of stone.

Flat warts are those that generally grow on the face, arms, or the legs. They are small with flat tops and candy pink, brown, or yellowish in color.

Filiform warts grow on the areas around the mouth, nose, or the beard. They are skin-toned and appear to have threadlike growths sticking out of them.

Periungual warts grow under the toenails and fingernails and look like rough bumps with uneven borders and surfaces. These warts affect nail growth.

How do warts spread?

Warts can be easily contracted when the patient gets in direct contact with HPV, you can get infected by simply touching the warts of another person. Similarly, you can infect other people by sharing personal items such as towels or razors, or anything that may get in contact with the other person’s skin. After contact with the HPV, it may take months before the development of the wart.

How are warts treated?

In general, warts do not need any special type of treatment, but in cases when they become painful and begin to spread to other parts of the body, or the person becomes bothered by the way they look, professional treatment or home treatments may be necessary. Home treatments such as salicylic acid may be obtained without a prescription. Stronger treatments including cryotherapy, electrosurgery, curettage, immunotherapy, or antiviral injections will require you to visit your doctor.

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