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What are warts?
In the vernacular, all changes protruding over the skin level are called warts. For medical specialists warts are sharply demarcated, benign skin growths (papillomas) variously shaped nostly with a rough crusty surface. They are caused by a contagious virus (Humanes Papilloma-Virus). Currently more then 80 different types of this virus are known.
The warts are subdivided according to their appearance and where they are located. They are caused on different spots by different under types of the virus. Normal warts (Verruca vulgaris) on hands and feet are common for children and young people and not so common for the older people. They often spread further over the skin, but they are not very contangious for other people. Plantar warts on the feet sometimes grow in deeply, which can cause a lot of pain. Flat warts (Verrucae planae) and filiform warts (Verrucae filiformes) can be often found on the face. Genital warts are much more contangous then common warts and can be transmitted via a sexual intercourse. Molluscum contagiosum are not part of this group. They are caused by a different virus group and look like differently: flat spherical structures with an umbilicus in the centre.
In Germany, almost every child has had warts once. The half of all adults has feet or hand warts. Warts are very well treatable, though sometimes they irritate the doctor and the patient because of their obstinancy. Warts can also disapear all by themselves.
How do warts appear?
Warts viruses get into the upper skin layer through small injures. They cause swelling and excessive skin hornification forming a typical wart shape.
Viruses multiply in the infected skin cells and are released to the surface. It is possible to be infected when touching the wart, especially if there is a small crack in the skin.
It is also possible to be infected with warts in the shower rooms of swimming pools; however the susceptibility for warts varies from person to person. The reason for that is unknown. Cold or sweaty hands or feet, with poor blood circulation (which is common for teenagers) are more susceptible.
How are warts diagnosed?
The appearance of the wart and the spot where it appears, lead to a clinical diagnosis. On hands and feet, they are rough, often lofty nodes with an irregular scaly surface. Sometimes there are small black points in the middle. Warts on the feet are sometimes distributed like a mosaic or a beet. On the spots that are exposed to a lot of pressure, such as feet, the hornification exerts pressure to nerves and causes pain similar to pain caused by stepping on a thorn. On the face and on other body spots warts often appear as inconspicious red, slightly rough elevations. In the genital area, genital warts stand out as small elevations which later on look like cauliflower and can grow pretty big if not treated (Buschke-Löwenstein tumor) and can even degenerate after years of existence.
In this very region, a dermatologist can dab a wart with ethanoic acid (3 %). It will then turn white on the contrary to the rest of the skin. This way nonvisible infection sites can be discovered.
An absolute security, whether it is a wart or something else, can be given by a biopsy.
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