Common wart in Infant/Neonate
See also in: External and Internal Eye,AnogenitalAlerts and Notices
Synopsis

Common warts, also known as verruca vulgaris, are caused by the human papillomavirus (HPV), most frequently HPV types 1, 2, and 4. Infection is usually at sites prone to frequent trauma such as fingers, hands, knees, and elbows, but common warts can occur on virtually any epidermal surface as well as mucosal surfaces. Warts may be pruritic, and scratching can produce a linear array of lesions via autoinoculation. Widespread, persistent lesions may be a clue to an underlying inherited or acquired immunodeficiency.
Verruca vulgaris lesions are more prevalent in children aged 4-12 years. The HPV virus is often passed between siblings and may be observed as cyclical infections.
Introduction of HPV into the anogenital area in children can be from several modes of transmission. Vertical transmission has been reported to be responsible for at least 20% of lesions. Horizontal transmission by caregivers in the first days of life is another modality of HPV contamination in newborns. There is also heteroinoculation by affected family members with common warts (verruca vulgaris) and autoinoculation from children who have a cutaneous or oral infection. Nevertheless, perianal and genital warts may be a sign of sexual abuse and must be investigated appropriately.
Verruca vulgaris lesions are more prevalent in children aged 4-12 years. The HPV virus is often passed between siblings and may be observed as cyclical infections.
Introduction of HPV into the anogenital area in children can be from several modes of transmission. Vertical transmission has been reported to be responsible for at least 20% of lesions. Horizontal transmission by caregivers in the first days of life is another modality of HPV contamination in newborns. There is also heteroinoculation by affected family members with common warts (verruca vulgaris) and autoinoculation from children who have a cutaneous or oral infection. Nevertheless, perianal and genital warts may be a sign of sexual abuse and must be investigated appropriately.
Codes
ICD10CM:
B07.8 – Other viral warts
SNOMEDCT:
57019003 – Verruca vulgaris
B07.8 – Other viral warts
SNOMEDCT:
57019003 – Verruca vulgaris
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Corns and calluses typically arise on the plantar surfaces of the feet and between toes. These lesions lack the punctate black dots seen in warts. Paring of a wart often better illustrates this feature.
- Condyloma acuminatum
- Molluscum contagiosum can be differentiated by the smooth, domed surface with umbilication.
- Enlarged sebaceous glands or epidermoid cysts
- Seborrheic keratosis
- Pigmented nevus
- Compound nevus
- Nevus sebaceus
- Epidermal nevus
- Skin tag
- Prurigo nodularis presents as a pruritic lichenified hyperpigmented papule or nodule.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:01/26/2021
Last Updated:01/26/2021
Last Updated:01/26/2021

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Common wart in Infant/Neonate
See also in: External and Internal Eye,Anogenital