Morphological characteristics and human papillomavirus genotype predict the treatment response in cutaneous warts

Summary

Skin warts are highly prevalent in both children and adults. They are caused by a virus called 'human papilloma virus' (HPV). Only around half of skin warts disappear after treatment. This study was performed to predict the type of HPV in warts and more importantly, to predict which warts are likely to disappear after treatment. Therefore, features both of patients and their warts were studied. A new standard tool for warts (the CWARTS diagnostic tool) was used to score the appearance of the wart and 23 different virus types were tested. The treatments that were used were monochloroacetic acid, cryotherapy or a combination of cryotherapy and salicylic acid. In total, 311 warts of 159 patients were studied. Black dots in a wart suggested presence of HPV. If warts contained HPV2, HPV27 or HPV57 they responded less often to most treatments. However this did not apply to warts located on the hands or body if they were treated with cryotherapy. Warts that show callus or are deeper located on the skin were less responsive to cryotherapy. To summarize, the appearance of warts and the type of HPV they contain influence the chance of healing. Therefore, in the future it might be important for medics to take this into account when choosing a treatment option for common and plantar warts.