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Presentation
Case Study: A 52-year-old man presents with possible calluses on either side of his thumb, forefinger, and middle finger. He reports cutting them off with nail clippers, but they return. He also reports using an over-the-counter wart treatment without success.
What is your diagnosis?
58% Calluses
157% Verruca vulgaris
27% Squamous cell carcinoma
78% Seborrheic keratosis
43% Contact dermatitis
The most likely diagnosis is verrucae vulgares, common warts. In some cases, calluses form over warts, as may have occurred in this case. Most warts are harmless, but are annoying to patients, especially when they return after they appear to have resolved.
Warts may itch or hurt, especially if they develop on the bottoms of the feet (plantar warts). Warts are most common in children, but can occur at any age.
Causes:
Warts are caused by the human papillomavirus (HPV) and can spread from one person to another or from one body part to another. They can appear on the hands, feet, or under the nails (subungual warts).
Treatment:
Most warts can be treated successfully with a mechanical therapy such as cryotherapy, electrocautery, or curettage. Topical treatments may be used, but data suggest that warts on the fingers tend to be resistant to topical treatments such as salicylic acid-based products. Systemic therapy may be used as well.
Genital warts, also associated with HPV, occur in the pubic area and require different treatment.