Definition

Wart is a small skin tumour (of skin) benign and contagious due to a virus: HPV, which can be inoculated and characterized by the accumulation of a lesser amount of keratin, adopting various configurations.

Classification

• Wart, extremely common within the population, the more mundane, particularly common in children and young adults, characterized by small reliefs in the form of dome of the horny layer, i.e. the surface of the skin layer of keratin. These élevures generally dry, grey and nature crouteuse, more or less prominent, either isolated or grouped in cupboards, resemble small nipples whose surface hyperkératosique (excess of keratin) is sometimes furrowed cracks. Their shape is variable, and they often sit on the dorsum of the hands and feet. It is possible to meet them also on the face and on the soles of the feet. Finally, they seem to appear most often in regions subject to trauma such as fingers, elbows, knees, etc…
• Dubreuilh Plantar warts are visible on the areas of support of the foot. Usually called Plantar warts, they can take 2 forms. The usual form, called myrmécie, is a slightly projecting wart of rounded shape whose edges are thick, dry and hard. This variety of wart, which is particularly painful pressure is sometimes confused with a durillon. Its evolution is towards growth in depth. The second form consists of small grains that appear to be inserted within a ring composed of relative large amount of keratin of firing on the white color. This form is less painful than the last. Quite often, the Plantar warts are transmitted through soils of swimming pools.
• Venereal vegetation (genital warts), also known as crêtes-de-coq, are small skin tumours which sit at the level of the anus or genitals.
• Digitate wart consists of several stacked warts to each other forming a sort of more or less large finger. It appears at the level of the scalp in adults where it is recognizable by its form clumps of flesh.
• Acrodigitée wart is the same as the previous but located on the fingers.
• Filiform wart consists of a stack of warts with a relatively small diameter. It has a thinner, elongated form. It occurs mainly at the level of the face (eyes, lips), in the hairs of the beard and neck. In some patients, it also sits on the eyelids and lips.
• Papillomateuse wart is characterized by a grouping of wart more or less spread. Also called Verrucous Papilloma, it sits on the face or scalp level and is based on a relatively constricted base. Their other characteristic is their end on grey and generally free.
• Juvenile flat warts are small papules (slightly embossed) especially on the face, the underside of the thorax (chest), the neck and the back of the hands. Their major feature is their small size and colour bistre very characteristic and their location.
• Pigmented warts are more precisely the tuberous melanistic naevi to warts that appear after the quarantine more particularly on the trunk and face.
• Dermatitis warts whose colour varies, ranging from clear or black chamois are not due to infection with human papillomavirus or another virus. This type of wart is particularly frequent and is essentially about individuals whose age exceeds 50 years. Most often, they are multiple and appear mainly on the back, chest and face. Seborrheic wart is likely to adopt a well delimited form whose surface of velvet and is slightly rough, with small ports corresponding to the end of the (dilated) channels and issuing the sebum. The sebum is a fatty substance that covers the skin and which is issued from the sebaceous glands.

Evolution of the disease

Evolution is variable and usually whimsical. It on the basis of many criteria:

• Degree of irritation
• Importance and number of injuries (both of the wart itself as individual psychological).

Sometimes, without reason, the warts disappear themselves after several months. The psychological context seems to play a role through the individual immunity. Indeed, the improvement of the psychological state of a person also seems to enrich its defence capabilities. The contagiousness of warts is variable depending on the type of human papillomavirus involved.

Differential diagnosis

Plantar warts should not be confused with the body or calluses. They rather tend to bleed as soon as their surface is decapitated.

Treatment

A dermatological consultation is necessary to make a treatment decision. In children, the Plantar warts are systematically processed. The techniques used to overcome the warts are the following:

• Generally, he is first tried stripping with petroleum jelly containing salicylates derivatives to 10 or 20% (acetylsalicylic acid: aspirin).
• Cryotherapy is a therapeutic method using cold in different forms (ice, frozen bags, liquid nitrogen, carbon dioxide snow), and gas (cryoflurane). Liquid nitrogen is not used for the treatment of Subungual or periungual warts. Indeed, warts located under the fingernails or their periphery are likely to re-offend frequently at this location.
• Simply cutting filiform warts to prevent re-offending.
• Dermatitis warts require destruction by cryotherapy, i.e. dry ice, liquid nitrogen, or electrocoagulation, laser carbon dioxide after local anesthesia.
• The electric scalpel (Electrosurgical) can also be used to remove warts.
• Applications of podophyllin (podophylox)-containing product
• Laser (with risk of SCAR)
• Therapeutic trials with injections of vitamin B are currently tempted with a few good results.
• In some patients, interferon and drugs such as immunomodulators (i.e. drugs to strengthen immunity) was attempted with more or less success.