Case history
Case history
A 7-year-old healthy girl presents with a rough bump on the lateral side of the right second finger that has been enlarging over the past 4 months. It has become fissured, bleeds when scratched, and becomes tender after manipulation. Physical examination reveals a fissured, grayish-white, raised hyperkeratotic papule with a rough surface. Gentle paring of the lesion reveals tiny black dots.
Other presentations
Common warts may affect any area of the skin. Warts may occur as individual lesions or in a mosaic pattern, as often happens on plantar surfaces. Lesions may range in size from pinpoint to 1 cm, averaging 5 mm. They usually affect the hands, where they favor fingers and palms. Periungual warts, which commonly affect nail biters, may become confluent around the lateral or proximal nail fold. Filiform warts have a stalk-like appearance, and represent one of the wart types that may occur on the face. The surface of a wart may be flat (as in flat warts), hyperkeratotic and scaly, or may have visible tiny black dots. The dots represent thrombosed capillaries. Occasionally, a slow-growing mother wart may give rise to multiple smaller warts in adjacent skin. New warts on previously healthy skin most likely result from autoinoculation of the virus from infected skin or from shaving. In nail biters, warts may spread from the fingers to lips and middle half of the tongue.[1][2]
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