WARTS

    Warts are lesions of the skin caused by skin cells that have become infected by human papillomavirus (HPV).  Lesions can appear anywhere on the skin however different strains are associated with different locations.  This is critically important because certain strains of HPV harbor oncogenes that can lead to cancer.  These strains are typically found in areas of sexual contact on or near the mucosa of the mouth, anus and genitalia, and occasionally the fingers or even the nose.  One thing warts share in common is they flourish when there is lack of an immune response.  For common warts it may take a few years for the body to create a proper immune response because the virus can live within skin cells undetected.  In some cases particularly with genital warts, the virus can lie dormant within skin and mucosal cells for years before emerging when the immune system fades either with age or because of disease or immunosuppressive therapy.  Some warts will only be expressed in individuals who have a genetic inability to fight the virus off (for example the tree man of Indonesia).

    Treatment of warts: 

    1. Destructive measures such as liquid nitrogen cryotherapy, blistering agents, or burning.  Agents that cause maceration fall into this category; this includes salicylic acid and occlusive coverings like duct tape.
    2. Therapies that enhance the immune response such as imiquimod, the stomach acid reducer cimetidine (shown to enhance the immune system of children), and oral zinc.
    3. Chemotherapy agents that kill rapidly dividing cells can be used for wart treatment; these include 5-fluorouracil and bleomycin.

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