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Periungual wart - Nail and Distal Digit
Other Resources UpToDate PubMed

Periungual wart - Nail and Distal Digit

Contributors: Shari Lipner MD, PhD, Bertrand Richert MD, Robert Baran MD, Susan Burgin MD
Other Resources UpToDate PubMed


Warts are infections of the epidermis with human papillomavirus (HPV). Warts that involve the periungual skin or subungual area are typically associated with HPV subtypes 1, 2, 4, 27, and 57. Butcher's warts may also affect the nail apparatus and are due to HPV 2 and 7. Warts are the most common nail tumor and affect fingernails more frequently than toenails. Warts are spread by human contact or indirectly via fomites on surfaces. Infection is more likely to occur when the skin is macerated or traumatized.

Warts involving the nails are fairly common in children. Warts of all kinds reach their peak prevalence in childhood and adolescence. Risk factors include atopic dermatitis, immunosuppression, nail biting, and nail picking.

In adults, warts are especially common among transplant patients and in individuals immunosuppressed due to human immunodeficiency virus infection (HIV), malignancy, or medications. They are also common in adults who do wet work, as well as in nail biters and nail pickers. There is a subset of ungual warts due to HPV 16 and 18 that are at higher risk of transforming into squamous cell carcinoma.


B07.8 – Other viral warts

43021004 – Periungual wart

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Last Reviewed:05/13/2018
Last Updated:06/20/2018
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Periungual wart - Nail and Distal Digit
A medical illustration showing key findings of Periungual wart : Hyperkeratotic cuticle, Nail fold tumor, Periungual fingers, Verrucous scaly papule
Clinical image of Periungual wart - imageId=1667003. Click to open in gallery.  caption: 'Verrucous papules at the proximal and lateral nailfold.'
Verrucous papules at the proximal and lateral nailfold.
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