Viral Warts in Kids
Abstract
Warts are common benign skin growths caused by infection with the human papillomavirus (HPV), frequently affecting children due to their developing immune systems and increased exposure to communal environments. These lesions typically appear on the hands, feet, and face, with common types including verruca vulgaris, plantar warts, and flat warts. While many warts in children resolve spontaneously within months to a few years. Management options include topical salicylic acid, cryotherapy, and immunomodulatory therapies, with treatment choice guided by wart type, location, patient age, and tolerance. Preventive measures such as hygiene education and avoiding direct contact with warts can reduce transmission. Effective homoeopathic remedies works and provide positive results in warts.
Keyword: warts in children, Human papillomavirus (HPV) , Homoeopathy
INTRODUCTION
Viral warts or verruca are common, benign skin growths caused by human papilloma virus (HPV). They are ubiquitous in the general population, but are more prevalent in children, affecting up to one third of school-going children.Approximately two-thirds of lesions can resolve spontaneously within 2 years without treatment. Indications for
treatment include pain, discomfort, recurrent bleeding and cosmesis. Early treatment is also important for epidemiological control and to prevent spread to close contacts. However, there is no consensus on the most efficacious and safest treatment option in children.
It involves the skin and mucosal surfaces. It is seen maximally in the school-going age group. The incubation period is 1-20 months (4 months average). Spread occurs through direct inoculation, use of contaminated objects and communal facilities. Genital warts are transmitted by sexual contact. Laryngeal papillomatosis can occur due to transmission in the perinatal period in children.
Classification:
Clinical types depending on sites involved are:
1. Verruca vulgaris: It manifests as a symptomatic, verruca [rough hyperkeratotic] and skin colored papules. Most common in school children on the dorsum of hands and feet.
2. Palmoplantar warts: It presented either small painful deep seated discrete papules with rough keratotic surface surrounded by horny collar [myrmecial warts or superficial, painless, multiple, small, hyperkeratotic papules merge together to form a large usually flat lesion. [mosaic warts].
3. Periungual warts: Warts around the nail are commonly associated with palmoplantar warts. Invasion of nail beds occurs and are recalcitrant to treatment. 4. Verruca plana or plane warts: These are small 1mm to 3mm in diameter discrete skin colored and hyper pigmented papules with small flat surface common on face, neck, extensor aspect of forearm and hands.
5. Filiform warts: These are single fingers like thin, firm, horny, projection common on face and neck.
6. Digitate warts: It presents with multiple finger-like warty projections form a common base seen commonly on the face, neck, and scalp.
7. Anogenital warts: Infection by sexually transmitted diseases. Commonly seen in adults. Children have anogenital warts child abuse must be ruled out. Clinically present as soft pink papules/plaques or as vegetating moist cauliflower like lesions.
Clinical Features
● Single or multiple fleshy papules.
● Dry surface, stippled with black dots.
● Pain may be present.
● Asymmetrical
Differential Diagnosis
● Molluscum contagiosum
● Seborrheic keratosis
● Lichen planus
● Squamous cell cancer
● Keratoacanthoma
Allopathic Management
● Chemical cautery
● Cryotherapy
● Electrocauterization
● Laser surgery
● Keratolytic agents -salicylic acid [10-20%]
● Formalin [2-3%] soaks in water for 15minutes for plantar warts.
Homoeopathic Approach
Miasm : Sycotic Miasm
Some Homoeopathic Remedies for Warts
● Antimonium Crudum: Horn-like excrescences and disposition to abnormal organisations of the skin. Horny warts on hands and soles. Dry skin. Horny growth under the nail. Crushed finger-nails grow in splits, with horny spots.
● Causticum: Warts on the arms. Warts, also with pain and inflammation. Warts of long standing on the nose. Warts of old-standing in the eyebrows; on the upper eyelid. Warts seedy, large, jagged, bleeding easily, ulcerating on tips of fingers and nose.
● Dulcamara: Warts on the hands. Eruptions and warts on the face. Warts are large, smooth, on the face and palmar surface of hands. Warts large, smooth, fleshy, flat.
● Natrum carbonicum: Warts; painful to touch. Dryne UV ss of skin. Warts on the back of hands. Dry, rough, cracked skin.
● Natrum muriaticum: Warts on palms of hands. Skin of hands dry and cracked, esp. round the nails. Skin dry, harsh, unhealthy or yellow.
● Nitricum acidum: Condylomata moist, like cauliflower, hard, rhagadic, or in thin pedicles. Dryness of the skin. Warts on arms. Roughness of skin of hands. Warts, large jagged; bleed on washing. Warts, condylomata: sycotic or syphilitic; large, jagged, pedunculated; bleeding readily on washing; moist, oozing, sticking pain.
● Staphysagria: Fig-warts pedunculated. Condylomata. Unhealthy skin. Dry skin.
● Thuja occidentalis: Warts epithelioma. Warts on hands; very numerous, esp. on dorsa; horny, painful. Warts on any part of the body, with little necks, called fig-warts, tubular warts, same size all the way out; “mother’s marks.”. Warts, hard, cleft, and seedy. Black sessile warts; on scalp
Reference:
1. Bacelieri R, Johnson SM. Cutaneous warts: an evidence-based approach to therapy. American family
physician. 2005 Aug 15;72(4):647-52.
Neena Khanna NK. Illustrated synopsis of dermatology and sexually transmitted diseases.
2. Kuruvila M. Essential dermatology, venereology and leprosy. Indian Journal of Dermatology, Venereology, and Leprology. 2005 May 1;71(3).
3. Irvine AD, Hoeger PH, Yan AC, editors. Harper’s Textbook of Pediatric Dermatology. John Wiley & Sons;
2011 Jul 28.
4. Boericke W. New manual of homoeopathic materia medica and repertory. B. Jain Publishers;2002;
About the Author:
Dr Jaggesha – Pg Scholar (Md Part -I ) , Department Of Paediatrics , Fmhmc Manglore
Under The Guidance Of
Dr Reshel Noronha
