{"id":4508,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/viralwarts\/"},"modified":"2024-10-09T12:51:18","modified_gmt":"2024-10-09T11:51:18","slug":"viralwarts","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/viralwarts\/","title":{"rendered":"Viral Warts"},"content":{"rendered":"\n<p>This information has been derived from recent National&nbsp;<a href=\"http:\/\/www.dermatology.nhs.scot\/dermatology-pathways\/pathways\/viral-warts\/\" target=\"_blank\" rel=\"noreferrer noopener\">Dermatology Guidelines<\/a><\/p>\n\n\n\n<p>Warts are caused by a common viral infection, the human papillomavirus (HPV). Most resolve spontaneously within a year or two. They may vary in appearance depending on the types of HPV, the anatomical site involved and the host immune response. They often have small black dots, representing coagulated capillaries, particularly evident on paring.<\/p>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:22% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"482\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Deep-plantar-warts.png\" alt=\"Deep plantar warts\" class=\"wp-image-19031 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Deep-plantar-warts.png 641w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Deep-plantar-warts-300x226.png 300w\" sizes=\"auto, (max-width: 641px) 100vw, 641px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Deep Plantar Wart (Verruca)<br><\/strong>May be tender on pressure&#8217;<\/p>\n\n\n\n<p>Image <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=deep%20plantar%20warts\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:22% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"642\" height=\"482\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Mosiac-plantar-warts.png\" alt=\"Mosiac plantar warts\" class=\"wp-image-19032 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Mosiac-plantar-warts.png 642w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Mosiac-plantar-warts-300x225.png 300w\" sizes=\"auto, (max-width: 642px) 100vw, 642px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Mosaic Plantar Wart<br><\/strong>May be slow to resolve in comparison to other warts<\/p>\n\n\n\n<p>image from <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=mosaic%20plantar\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:22% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"482\" height=\"482\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Plane-warts.png\" alt=\"Plane warts\" class=\"wp-image-19033 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Plane-warts.png 482w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Plane-warts-300x300.png 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Plane-warts-150x150.png 150w\" sizes=\"auto, (max-width: 482px) 100vw, 482px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Plane Wart<br><\/strong>Flat topped pink or pale brown. Often on face or other sun exposed sites<\/p>\n\n\n\n<p>Image from <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=plane%20warts%20facial&amp;gsc.page=1\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:22% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"642\" height=\"482\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Filiform-facial-wart.png\" alt=\"Filiform facial wart\" class=\"wp-image-19034 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Filiform-facial-wart.png 642w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Filiform-facial-wart-300x225.png 300w\" sizes=\"auto, (max-width: 642px) 100vw, 642px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Filiform Facial Wart<\/strong><\/p>\n\n\n\n<p>image from <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=Filiform%20Facial%20Wart&amp;gsc.page=1\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:22% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"480\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Common-wart.png\" alt=\"Common wart\" class=\"wp-image-19274 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Common-wart.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Common-wart-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Common hand warts<\/strong><\/p>\n\n\n\n<p>image from <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=common%20hand%20wart\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<p>All images on this page are sourced from <a href=\"https:\/\/dermnetnz.org\/\">DermNet | Dermatology Resource (dermnetnz.org)<\/a><\/p>\n\n\n\n<p><strong>R.C 07-05-24<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Criteria for Referral<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Symptomatic warts persistent for at least two years and unresponsive to topical agents and cryotherapy.<\/li>\n\n\n\n<li>Diagnostic uncertainty especially in the elderly.<\/li>\n\n\n\n<li>Multiple recalcitrant warts in the immunosuppressed.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Most patients with viral warts can be managed in primary care.<\/p>\n\n\n\n<p>Consider no&nbsp; treatment as warts usually resolve spontaneously<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Common hand warts<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Self treatment daily with salicylic acid (up to 26%) or glutaraldehyde paints or gels after paring the warts<\/li>\n\n\n\n<li>Continue treatment for at least three months then review<\/li>\n\n\n\n<li>Consider 3-weekly cryotherapy in non-responders, occlusion under waterproof plaster, and use in combination with topical therapy<\/li>\n\n\n\n<li>Cryotherapy may be distressing and therefore inappropriate for young children<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Deep plantar wart \/ mosaic plantar warts<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Self treatment with daily salicylic acid paint (up to 50%)<\/li>\n\n\n\n<li>Paring of plantar warts with single-use file enhances treatment response<\/li>\n\n\n\n<li>Consideration of cryotherapy three weekly for up to 10 treatments: single or double freeze thaw cycle(s)<\/li>\n\n\n\n<li>Patients with painful plantar warts can be treated with corn plasters<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Plane warts<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Plane warts often resolve spontaneously<\/li>\n\n\n\n<li>Avoid cryotherapy<\/li>\n\n\n\n<li>Apply topical retinoic acid if persistent<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Filiform facial warts<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Do not apply wart paints<\/li>\n\n\n\n<li>Treat filiform facial warts with careful cryotherapy for 5-10 seconds to the wart but avoid surrounding skin<\/li>\n\n\n\n<li>Repeat every 2 or 3 weeks<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Therapeutic Tips<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Do not use salicylic acid on the face<\/li>\n\n\n\n<li>Cryotherapy should be administrated by appropriately trained staff<\/li>\n\n\n\n<li>Diagnostic doubt over solitary wart: remove by curettage for histopathology<\/li>\n\n\n\n<li>Children with verrucae should not be banned from swimming pool but can wear verruca socks<\/li>\n<\/ul>\n\n\n\n<p><strong>Link to PCDS&nbsp;<a href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/warts\" target=\"_blank\" rel=\"noreferrer noopener\">Warts guidance<\/a><\/strong><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This information has been derived from recent National&nbsp;Dermatology Guidelines Warts are caused by a common viral infection, the human papillomavirus (HPV). Most resolve spontaneously within a year or two. They may vary in appearance depending on the types of HPV, the anatomical site involved and the host immune response. They often have small black dots,<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3853,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[114],"class_list":["post-4508","page","type-page","status-publish","hentry","category-viralwarts"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dermatology\/viralwarts\/\" rel=\"tag\">Viral Warts<\/a>","rttpg_excerpt":"This information has been derived from recent National&nbsp;Dermatology Guidelines Warts are caused by a common viral infection, the human papillomavirus (HPV). Most resolve spontaneously within a year or two. They may vary in appearance depending on the types of HPV, the anatomical site involved and the host immune response. They often have small black dots,","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4508","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4508"}],"version-history":[{"count":16,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4508\/revisions"}],"predecessor-version":[{"id":21159,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4508\/revisions\/21159"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4508"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4508"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}