Skin nontumor
Infectious disorders

Topic Completed: 1 July 2011

Minor changes: 16 November 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Warts [title] skin

Mowafak Hamodat, M.B.Ch.B., M.Sc.
Page views in 2019: 25,540
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Cite this page: Hamodat M. Warts. website. Accessed November 23rd, 2020.
Definition / general
  • Also called verrucae
  • Cutaneous and mucosal lesions are caused by various types of human papillomaviruses (HPV), a type of papova virus
  • Usually resolves in 6 - 24 months

  • Verruca plana:
    • Usually due to HPV10
    • Flat, occurs in crops / clusters on face and hands

  • Verruca plantaris:
    • On soles of feet; painful
    • Covered by calluses

  • Verruca vulgaris:
    • Usually due to HPV2
    • Occur on hands as elevated, hard, rough, flesh-colored lesion
    • If surface is peeled, undersurface is pink and granular
Clinical features
  • Verruca vulgaris:
    • Exophytic papules, either single lesions or linear; appear serrated
Case reports
Clinical images

Images hosted on other servers:

Verruca plana following eyebrow threading

Verruca plantaris

Verruca vulgaris

Microscopic (histologic) description
  • Focal epidermal hyperplasia with hyperkeratosis, parakeratosis and papillomatosis (not verruca plana); may have trichilemmal keratinization
  • Koilocytes (keratinocytes in upper squamous layer with vacuoles, large cytoplasmic eosinophilic aggregates and pyknotic nuclei)
  • Tangential sections may show squamous cells surrounded by inflamed stroma
  • Older lesions may lack cytoplasmic changes
  • Viral nuclear inclusions are basophilic

  • Verruca plana:
    • Involuting lesions may have chronic inflammatory infiltrates in dermis and epidermis with degenerative epithelial changes

  • Verruca plantaris:
    • Invaginated with numerous coarse, basophilic, intracytoplasmic keratohyalin granules resembling molluscum bodies

  • Verruca vulgaris:
    • Striking papillomatosis (upward displacement of dermal papillae), stratum corneum exhibits parakeratosis with pointed mounds resembling church spires, extravasated erythrocytes or hemosiderin
    • Granular layer is thickened with prominent keratohyalin granules and keratinocytes displaying perinuclear clearing (koilocytosis, lost in older lesions)
    • Lymphocytic infiltrate in upper dermis
Microscopic (histologic) images

Contributed by Angel Fernandez-Flores, M.D., Ph.D.

Various images

Images hosted on other servers:

Verruca plana

Positive stains
  • HPV by in situ hybridization
Electron microscopy description
  • Eosinophilic aggregates are tonofilaments
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