Diagnosis: Verruca Vulgaris (lips)
Submitted by Alaa Saad to dermRounds Dermatology Network
Submitted by Alaa Saad to dermRounds Dermatology Network
Skin-colored, rough, keratotic papules with disrupted skin lines. Common on hands and feet. Spread by direct contact or autoinoculation.
Salicylic acid (first-line OTC). Cryotherapy with liquid nitrogen. Cantharidin. Immunotherapy: intralesional Candida antigen, squaric acid. Refractory: bleomycin intralesional, 5-FU, laser. HPV vaccine may have adjunctive benefit.
• Seborrheic keratosis • Squamous cell carcinoma • Keratoacanthoma • Molluscum contagiosum • Actinic keratosis • Corn/callus (plantar warts) • Amelanotic melanoma
• Caused by Human Papillomavirus (HPV) — types 1, 2, 4, 7 most common for common warts • Thrombosed capillaries appear as "black dots" — this distinguishes from callus/corn • Spontaneous resolution occurs in ~65% within 2 years in immunocompetent individuals • Disruption of normal skin lines (dermatoglyphics) helps differentiate from callus • Butcher's warts (HPV 7): large, cauliflower-like warts in meat handlers • Koebner phenomenon: warts spread along lines of trauma • Multiple treatment modalities needed — no single treatment is universally effective
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