History and exam
Key diagnostic factors
common
presence of risk factors
Risk factors include: water immersion, occupations involving handling of meat or fish, nail biting behaviour, young age (<35 years), and an immunocompromised state.
lesion growth over weeks to months
Lesions may range in size from pinpoint to 1 cm, averaging 5 mm.
round, raised papule
Characteristic appearance of common wart.
tiny black dots on surface of lesion
May be seen after gentle paring of the lesion with a scalpel.
Represent thrombosed capillaries.
Other diagnostic factors
common
satellite lesions
fingers or nail fold lesions
Common warts frequently affect the hands, fingers, and periungual areas.
facial lesions
Filiform warts commonly affect facial skin.
fissuring
Common warts may fissure, bleed, and cause pain.
hyperkeratosis
Presenting as a rough, scaly appearance.
greyish-white or light brown colour
Characteristic colour of a common wart.
filiform papule with sharp spikes
Appears to emerge from the skin from a stalk.
Risk factors
strong
water immersion
Swimming and regular dishwashing, for example, are risk factors.
occupations involving handling of meat or fish
Common warts show a prevalence of 50% in people who have direct contact with meat.
nail biting
age under 35 years
Only 15% of common warts occur in patients older than 35 years.
immunocompromised
Immunocompromised patients are more susceptible and tend to have more lesions, and occasionally increased lesion size and different morphology, compared with immunocompetent individuals.
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