Investigations
1st investigations to order
no initial test
Test
Diagnosis can usually be made on the basis of the history and physical examination.
Result
clinical diagnosis
Investigations to consider
skin biopsy
Test
Characteristic features include hyperkeratosis, church spire papillomatosis, elongated rete ridges, koilocytes (virus-infected cells with eccentric nuclei and viral inclusions), and prominent dermal vessels.
Histopathological analysis may be useful in some cases, especially when it is necessary to differentiate a common wart from a human papillomavirus-induced squamous cell carcinoma, seborrhoeic keratosis, fibrokeratoma, or other lesions that mimic warts.
Result
features of common warts
immunoperoxidase stain
Test
Immunohistochemistry may reveal presence of the human papillomavirus (HPV) antigen; sensitivity is low.
Result
presence of HPV capsid antigen
skin culture
Test
Primarily required to rule out other deep fungal, bacterial, or mycobacterial infections in immunocompromised patients with severe lesions.
Result
presence of human papillomavirus
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