Severe case of warts affecting both hands

Diagnosis: Severe case of warts affecting both hands

Submitted by Dr.Azeem Alam Khan to dermRounds

Clinical Presentation

Warts Submitted by Dr.Azeem Alam Khan to dermRounds

Clinical History

Rough, keratotic papule. Common on hands and feet. Spread by direct contact.

Treatment

Salicylic acid, cryotherapy, cantharidin. Refractory: intralesional immunotherapy, bleomycin.

Differential Diagnosis

• Seborrheic keratosis • Squamous cell carcinoma • Molluscum contagiosum • Corn/callus • Actinic keratosis

Key Learnings

• Caused by Human Papillomavirus (HPV) • Thrombosed capillaries appear as "black dots" • Spontaneous resolution in ~65% within 2 years in immunocompetent patients • Multiple treatment approaches often needed

Tags: dermatologist, dermatology, warts