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Wart

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A new article published in StatPearls discussed that warts are prevalent benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. Warts may cause significant morbidity for affected individuals. 
 
It was stated that after a confirmatory diagnosis, the treatment depends on symptoms, patient preferences, and cost. Despite many treatments are available, none is very effective, and recurrences are common, irrespective of the modality chosen. In general, one should try the least expensive and least painful treatment first. While the more expensive and invasive treatments are usually reserved for multiple recurrent warts. 
 
Often, a ‘wait and watch’ strategy is adopted; it is known that nearly two-thirds of warts spontaneously disappear within 24 months. The only negative aspect is that there is a small risk that the wart can enlarge and may even spread to other areas. Usually, topical agents are utilized first – salicylic acid is often a first-line agent for the common wart. It it available over-the-counter and can be used by the patient at home; the cure rate is 50% to 70%. Cryotherapy, retinoic acid, podophyllin, topical 5-fluorouracil, interferon and imiquimod are other treatment options.
 
Cidofovir has been used to treat CMV infections in HIV patients and has been found to be efficacious in patients with recalcitrant warts, in several instances. Additionally, 5-Fluorouracil is used to treat actinic keratosis and has been used to treat warts under occlusion for 30 days. The vitamin A derivative, tretinoin, has been used with partial success to treat flat warts. Intralesional injections with immunotherapy (candida), bleomycin, and interferon alfa have also been reported to work in some patients. Systemic treatments that have been tried include cidofovir, cimetidine and retinoids.
 
Furthermore, nonpharmacological therapies used include – adhesiotherapy, hypnosis, hyperthermia, propolis and a number of plant extracts. Surgical treatments include – cryotherapy, laser, electrodesiccation and excision.
 
Source: Updated 2020 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
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