Viral Infections

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Signs and Symptoms

Common warts appear most often on the tops of the fingers and hands, usually along the cuticles, as rough, thick, cauliflowerlike papules that develop solitarily or in large numbers. Black dots, which are minute blood vessels, can be seen in them, especially after paring down some of the thickened skin. Small satellite warts may surround the original lesion because the virus is usually present in a one-centimeter radius surrounding the wart.

Flat warts are small, slightly elevated, flat-topped, pink or tan papules, are smoother than the common wart, and have minimal scale. They occur primarily on the face, arms, and legs, and a person can have several, even hundreds of them.

Plantar warts occur on the soles of the feet, are often thick and callused, grow inward, and can be quite painful and bothersome. Tiny clusters of warts, called mosaic warts, are particularly stubborn and resistant to treatment.

Ano-genital warts (condyloma acuminata) are flesh to gray in color, grow in mucous membranes, and vary in size from small, shiny papules, to large cauliflowerlike lesions. They can extend internally into the vagina and cervix, the rectal area, and inside the urethra (the tube through which urine is voided from the bladder).

Most of these warts are painless, but there can be itching and burning, and they can progress to more serious disease (e.g., cervical cancer), regress, or remain at their primary growth stage. Anyone who has genital warts should have them examined by a physician.

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