These are so common that most people will have them at some stage in their lives. They present as small, firm lesions with a rough surface, varying in size from 1mm to 1cm, that may appear anywhere on the skin. Most commonly on the feet or, as in this patient, the hands. They are particularly common on the fingers and knuckles. They are caused by the human papilloma virus (HPV), of which there are over 100 different types. These 'common warts' are most often associated with types 2 and 4, but also 1,26,27,29,41 and 57, not those that may have potential for malignant change. They are transmitted by direct skin to skin contact with someone with warts and spread is more likely to occur if the skin is damaged or wet, so spread is also more likely from contaminated floors, for example, in swimming pools or bathing areas. The most likely outcome is spontaneous resolution within two years, and this should be encouraged unless the patient complains of troublesome symptoms or the lesions are cosmetically unsightly.
Please login or register to read the rest of the article and to have access to downloads and comments.