Periungual warts are warts that cluster around the fingernail or toenail. They appear as thickened, fissured cauliflower-like skin around the nail plate. Periungual warts often cause loss of the cuticle and paronychia. Nail biting increases susceptibility to these warts.[1]
| Periungual wart | |
|---|---|
 | |
| Periungual warts over 18 weeks of treatment | |
| Specialty | Dermatology |
Warts of this kind often cause damage to the nail either by lifting the nail from the skin or causing the nail to partially detach. If they extend under the nail, then the patient may suffer pain as a result. Sometimes periungual wart infections resemble the changes that are found in onychomycosis. In worst cases, if the infection causes injury or damage to the nail matrix, deformity in the nail may become permanent.
As with other wart types, a number of treatments are available, including laser therapy, cryotherapy, salicylic acid, and other topical treatments.
Signs and symptoms
editPeriungual warts are warts that develop next to the hand and foot nails. Usually, warts appear as tiny, scratchy papules that resemble cauliflowers. Black puncta, which are microscopic blood vessel-representing dots, frequently form at the core of hyperkeratotic, dome-shaped lesions. If the growth is cut down, this could potentially result in pinpoint bleeding.[2]
Diagnosis
editUsually, a clinical examination is enough to make a diagnosis. Immunocompromised patients or those with resistant, protracted warts should get a biopsy to rule out high-risk HPV strains, Bowen's disease, and squamous cell carcinoma.[2][3]
Treatment
editTreatment options for warts encompass topical, intralesional, and laser therapy. Surgical methods include excision and electrodesiccation, which use electrical current to destroy tissue, although they are not recommended as first lines of treatment because of the possibility of scarring and recurrence.[2][4]
References
edit- ^ "Warts - Dermatologic Disorders - Merck Manuals Professional Edition". merck.com.
- ^ a b c Reich, Danya; Psomadakis, Corinna Eleni; Buka, Bobby (2017). "Periungual Warts". Top 50 Dermatology Case Studies for Primary Care. Cham: Springer International Publishing. pp. 55–60. doi:10.1007/978-3-319-18627-6_9. ISBN 978-3-319-18626-9.
- ^ Riddel, Catherine; Rashid, Rashid; Thomas, Val (2011). "Ungual and periungual human papillomavirus–associated squamous cell carcinoma: A review". Journal of the American Academy of Dermatology. 64 (6). Elsevier BV: 1147–1153. doi:10.1016/j.jaad.2010.02.057. ISSN 0190-9622. PMID 21315482.
- ^ Tosti, A.; Piraccini, B. M. (2001). "Warts of the nail unit: surgical and nonsurgical approaches". Dermatologic Surgery. 27 (3): 235–239. ISSN 1076-0512. PMID 11277888.
Further reading
edit- Du, Lingyun; Cao, Zhiqiang; Liu, Zhaoyang; Zhu, Xia; Zhang, Chunhong (2022). "Successful Treatment in a Child with Refractory Periungual Warts by Local Hyperthermia: A Case Report". Clinical, Cosmetic and Investigational Dermatology. 15. Informa UK Limited: 2617–2620. doi:10.2147/ccid.s390192. ISSN 1178-7015. PMC 9738090. PMID 36510605.
- Alghamdi, Khalid M.; Khurram, Huma (2011). "Successful Treatment of Periungual Warts with Diluted Bleomycin Using Translesional Multipuncture Technique: A Pilot Prospective Study". Dermatologic Surgery. 37 (4): 486–492. doi:10.1111/j.1524-4725.2011.01932.x. ISSN 1076-0512. PMID 21414076.
- Poppens, McKayla; Davis, Jeremy (2023-12-31). "Intralesional cidofovir for the treatment of recalcitrant periungual warts". Journal of Dermatological Treatment. 34 (1). doi:10.1080/09546634.2022.2154569. ISSN 0954-6634. PMID 36453608.