A elderly patient visits the pharmacy, alarmed he has developed a crop of viral warts over both his hands. He says he recently visited his grandchildren, both of whom have verrucas.

QUESTIONS

1. The source of the causative virus may have been a verruca. True or false?

2. Treatment is advisable for verrucas and warts regardless of severity, as very few will resolve otherwise. True or false?

3. Covering the warts with tape (such as duct tape) is a cheap and painless way to treat them and is particularly good for lesions around the nails. True or false?

4. Paring down hard hyperkeratotic warts should be avoided, as this will make them grow faster and may cause them to spread. True or false?

5. If the diagnosis is in doubt, bleeding after paring down is a good diagnostic sign of a verruca or wart. True or false?


DISCUSSION

1. True. Both viral warts and verrucas are caused by the human papillomavirus, of which more than 100 types have been identified.

2. False. Treatment is not necessary as 30 per cent will usually settle after 10 weeks, and most will have gone after 1-2 years.

3. True. Studies have shown that duct tape occlusion is a simple form of treatment, and is particularly useful in young children.

4. False. Thick warts should be pared down, which will increase the effectiveness of all treatments.

5. True. Warts and verrucas typically contain blood vessels which bleed, whereas corns and areas of simple hyperkeratosis do not.