Prognosis
Most common warts will resolve spontaneously in immunocompetent individuals. Clearance rates in children from time of diagnosis to clearance are 23% at 2 months, 30% at 3 months, 65% to 78% at 2 years, and 90% at 5 years.[51] Resolution may be significantly hastened with therapy.
Recalcitrant warts and lesions in immunocompromised patients are less likely to resolve spontaneously, and may require more aggressive intervention and histological analysis to rule out squamous cell carcinoma (SCC).
Because human papillomavirus (HPV) is fairly ubiquitous in the general healthy population, skepticism exists as to whether cutaneous HPV infection is causally involved in non-melanoma skin cancer (NMSC) development. However, a significant association has been reported between beta HPV and HPV subtypes 5, 8, 17, 20, 24 and 38, and an increased risk of cutaneous SCC development in immunocompetent individuals.[52]
Similarly, SCCs in immunosuppressed patients have a higher association with HPV than SCCs in immunocompetent patients.[53]
Other studies have reported HPV DNA in 30% to 50% of NMSCs in immunocompetent patients, and in 90% of NMSCs in immunosuppressed patients.[54][55]
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