Flat wart in Child
The warts arise from benign strains of HPV and are not known to cause cancer. They are contagious and spread easily over the body. Transmission is commonly via person-to-person contact or via fomites. Existing skin trauma (ie, cuts, scratches, burns, eczema) predisposes patients to contracting HPV. A person with flat warts may spread the warts to a different part of the body (autoinoculation) through trauma to the skin such as scratching or shaving.
Children, young adults, and immunocompromised patients are most susceptible. In the younger population, approximately 23% of warts will resolve within 2 months, and 78% of warts disappear within 2 years of onset. Shaving in the young adult population can lead to autoinoculation. Widespread or extensive warts are often presenting signs of an immunocompromised state. Warts may be more numerous and more difficult to treat in immunocompromised patients. Excessive sun exposure can lead to an exacerbation.
B07.8 – Other viral warts
240539000 – Flat wart
Differential Diagnosis & Pitfalls
- Common warts
- Acne vulgaris
- Molluscum contagiosum
- Lichen planus
- Lichen nitidus
- Epidermodysplasia verruciformis – A genetic disorder characterized by diffuse flat warts and a high potential for squamous cell carcinoma transformation. Consider this when evaluating a patient with diffuse flat warts. Evaluate for a family history, especially in a young patient with new diagnosis of flat warts.
- Papular epidermal nevus with "skyline" basal cell layer (PENS) is a rare, newly described entity where affected children develop few hyperkeratotic polygonal or rectangular papules in one or more body locations. PENS syndrome describes a subset of patients with PENS with associated neurological findings such as epilepsy or neurodevelopmental delay.