Key Points

  • Verrucae (warts) are common yet benign cutaneous lesions caused by human papillomavirus (HPV) that can be challenging to treat.
  • The therapeutic strategy involves destruction of lesions through a variety of techniques; selecting the best technique to treat warts depends on the type of wart involved, the location, and response to prior therapies.
  • Warts will often resolve spontaneously without sequelae or scarring, thus therapy should be judiciously used to avoid scarring.
  • Warts in immunocompromised individuals are very common, difficult to treat, and potentially oncogenic.

Introduction

Human papillomavirus-induced lesions (warts) are a common but vexing problem, as no ideal therapy exists. For therapeutic purposes there are three basic types of warts: flat warts (verruca plana); common warts (verruca vulgaris) and plantar warts; and genital warts (condyloma acuminata). The different wart types are caused by distinct strains of HPV: flat warts (HPV3), common warts (HPV2, 4), plantar warts (HPV1), and genital warts (HPV6, 11). The therapy for each wart type is discussed separately. Warts in the immunosuppressed are common, therapeutically difficult, and potentially oncogenic, and therefore are discussed separately.

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