Verrucae



Verrucae


David Cassarino, MD, PhD










Clinical photograph shows multiple verrucae on the dorsal hand and fingers. (Courtesy J. Wu, MD.)






Palmoplantar warts (myrmecia) often show especially prominent koilocytes with perinuclear halos image and large, dense keratohyaline inclusions image.


TERMINOLOGY


Abbreviations



  • Verruca vulgaris (VV)


Synonyms



  • Common warts


  • Variants



    • Palmoplantar warts (myrmecia)


    • Flat warts (verruca plana)


Definitions



  • HPV-related benign epidermal proliferation


ETIOLOGY/PATHOGENESIS


Infectious Agents



  • Causal relationship established with numerous HPV types, including HPV 1, 2, 3, 4, 7, 10, 27, 29, 57



    • Most common types include 1, 2, 3, 4, 7, 10


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Very common lesions


  • Age



    • Common in children and young adults but can occur at any age


Site



  • Common sites include fingers and dorsal hands (verruca vulgaris), palms and soles (palmoplantar warts), face and dorsal hands (flat warts)


Presentation



  • Small papular to plaque-like lesions


Natural History



  • Grow rapidly, then stabilize


  • Some lesions may regress


Treatment



  • Surgical approaches



    • Complete excision is curative but not necessary in most cases


  • Drugs



    • Topical therapy with podophyllin or other antiviral medications


Prognosis



  • Excellent, unless immunosuppressed



    • Rare cases of cutaneous carcinoma are associated with various HPV types, especially in immunosuppressed patients


MACROSCOPIC FEATURES


General Features



  • Often exophytic-appearing scaly (hyperkeratotic) lesion


Size



  • May be small (several mm) papules to large plaques (several cm)


MICROSCOPIC PATHOLOGY


Histologic Features

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Verrucae
Premium Wordpress Themes by UFO Themes
%d bloggers like this: