Warts: (Common and Plantar)

Presentation

Patients generally seek medical care when a wart has become painful, partially avulsed, cosmetically unacceptable, or otherwise annoying.

Common warts usually appear as one or more dome-shaped hyperkeratotic verrucous papules on the hands but may occur anywhere on the body. Plantar warts occur on the soles of the feet, interrupting the normal skin lines and frequently occurring at points of maximum pressure, such as over the heads of the metatarsal bones or on the heel. Plantar warts do not have a verrucous or cauliflower appearance but are surrounded by a thick painful callus that impairs walking. Both types of wart contain black dots within their substance, which represent thrombosed capillaries ( Figs. 186.1 and 186.2 ).

These lesions may appear at any age but commonly occur in children and young adults. Their course is highly variable; most resolve spontaneously in weeks or months, and others may last years or a lifetime.