Diagnosis: Verruca Vulgaris (periungual)
Large, thick, hyperkeratotic periungual and subungual wart.
Large, thick, hyperkeratotic periungual and subungual wart.
Submitted by Alaa Saad. Originally posted October 22, 2010.
See case discussion.
• 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
Tags: verruca, vulgaris, periungual, alaa saad