HUMAN PAPILLOMA VIRUS INFECTION (WARTS)

• Warts or Verrucae are benign proliferations of the skin and mucosa that result from infection with papilloma virus. These viruses do not produce acute signs or symptoms but induce slow growing lesions that can remain subclinical for long periods of time
• Warts is a hyperkeratosis and hyperplasia of epidermis commonly caused by human papillomavirus (HPV)

• Transmitted by direct skin contact
• Impairment of epithelial barrier function by moisture and trauma is pre disposing factor
• Common clinical manifestation of HPV

• Warts assume many clinical forms
• Common warts (verruca Vulgaris): characterized by symptomless, firm papules with a rough horny surface. They are most commonly situated on the back of hands and fingers. Appearance is skin-colored or whitish (sometimes with a cauliflower-like appearance) 
• Flat warts (verruca plana): Localized to face, back of the hand, legs. Appears as flesh-colored, smooth papules, flat surface
• Plantar wart (verruca plantaris): usually localized to the soles of the feet. A plantar wart at first appears as a small, shining, sago grain papule, but soon assumes the typical appearance of a sharply defined, rounded lesion, with a rough keratotic surface surrounded by a smooth collar of thickened horn
• Filiform or digitate wart: occur commonly in the male, on the face and neck. They are irregularly distributed, often clustered
• Anogenital warts: 30 to 50% of sexually active adults are infected with HPV. Most of them occur on the penis, scrotum, urethral meatus, and perianal area in men and on the introitus, vulva, perineum, and perianal area in women. Four morphological types are cauliflower-like(condyloma acuminate), popular, Keratotic, Flat-topped

 Differential diagnosis

• Corns: Epidermal ridges continue without interruption in warts, and corns have a hard painful translucent central core

• Usually clinical diagnosis is done
• Laboratory confirmation of HPV
• Histopathology of lesions - Epidermal hyperplasia, Irregular hyperkeratosis, Koilocytes, Papillomatosis

• Surgical excision 
• Warts may recur and require multiple treatments

Internal medicines

• Guduchyadi kashaya
• Vilwadi gutika
• Guggulu tiktaka ghrita

Procedure

• Guggulu marichadi taila – ext application
• Yashti choorna + Triphala application
• Vilwadi gutika + lime + kalyanaka kshara + Tulasi swarasa ext application