Which are the symptoms?
The viral infection is generally asymptomatic, some patients may report mild itching, sometimes pain (such as in walking and pressure in case of plantar warts), discomfort (localizations in visible and genital areas) and functional distress (localizations in periorificial areas). Larger lesions can become macerated and ulcerated with secondary overinfection.
How is it diagnosed?
The diagnosis is primarily clinical. The shape, surface and localization allow to define the diagnosis. The disappearance of normal skin furrows (dermatoglyphics) and the presence of thrombized capillary vessels are easily found in plantar warts. Dermoscopy allows to observe specific patterns such as the dotted mosaic pattern, the knoblike pattern and the fingerlike pattern.
To support the physician, in cases where the clinic is not well defined, it is possible to implement other methods of help such as the 5% acetic acid test and biopsy with histological examination. The infection can also remain in a subclinical phase with the presence of viral particles and absence of skin and mucosal changes, or in a latent phase with the presence of viral DNA in the tissue that can be detected with specific diagnostic techniques (HPVscreening/qualitative PCR analysis and HPV genotyping). In case of genital or anal localization it would be appropriate to integrate with the execution of colposcopy, anoscopy and urethroscopy.
How is it treated?
The type of treatment depends on the type (vulgar, flat, mosaic), location, number and size of lesions, as well as the age of the patient and any associated diseases (diabetes, allergies). The treatment aims to prevent the spread of warts to other body sites or other individuals, eliminate functional disorders related to the presence of warts also in relation to the aesthetic and psychological motivations of the patient.
Regardless of the type of treatment performed, there are rather resistant forms and recurrence rates are reported in about 30% of cases.