Filiform warts is an elongated formation of elastic consistency with a size of 5-6 mm. It occurs on the skin of the face and neck, under the mammary glands and in the armpits. Filiform warts are caused by the human papillomavirus and tend to spread to neighboring areas of the body. Diagnosis is based on the data of dermatological examination and dermatoscopy. In the treatment, along with the removal of filiform warts by cryotherapy, electrocoagulation, laser and surgical excision, HPV therapy is recommended.
Filiform warts can occur at any age, but they are more often found in the elderly. According to some studies, about half of people over the age of 50 have filiform warts. Together with skin neoplasms such as papillomas, other types of warts, filiform warts are a manifestation of HPV. Infection with the virus can occur through scratches and microcracks on the skin. Therefore, people with dry skin are more prone to HPV infection and the appearance of filiform warts.
Clinical dermatology notes that this type of warts often occurs against the background of any hormonal changes. They can appear during pregnancy, during menopause, with obesity, diabetes mellitus. Among young women, filiform warts are most often found against the background of ovarian dysfunction and infantilism.
A threadlike wart appears on unchanged skin in the form of a yellowish bump. As it grows, it stretches out, turning into an oblong formation, as if hanging on a leg. The wart has an elastic and dense consistency, its typical length does not exceed 5-6 mm, but it can reach up to 1 cm. In some cases, several warts appear nearby, fusing together, they transform into a single formation in the form of cauliflower or cockscomb. In color, acrochords often do not differ from normal skin, but can have a color of varying intensity up to dark brown.
Usually filiform warts are localized on the face, eyelids, chin, around the mouth, in the area of the lips and nose. Single acrochords are found in the axillary areas, in women — under the mammary glands.
filiform warts are not prone to malignancy, but their injury can lead to its inflammation and promotes the spread of HPV to other areas of the skin, where new warts are subsequently formed. If a thread wart is accidentally detached, a new one grows in its place. Spontaneous disappearance of this type of warts is noted only in very rare cases. Sometimes there is keratinization of the wart and its transformation into a skin horn.
The diagnosis of neoplasms is carried out at the consultation of a dermatologist. Examination and dermatoscopy are usually enough to confirm the diagnosis to the doctor. When examining the wart under magnification, vascular thrombosis and angiopathy are detected in the filiform growths, which indicates the viral genesis of the formation. To confirm the infection of the HPV patient, the virus is determined by PCR. In some cases, a biopsy with histological examination of the wart tissues may be required. A threadlike wart is differentiated from a mole, an ordinary wart, papilloma, fibroma on the leg.
In order to avoid injury to the thread wart and the spread of HPV, patients should take some precautions. When localization of education in the neck area, it is necessary to exclude wearing clothes with a tight collar, irritating wool or synthetic scarves, large and heavy beads. When a threadlike wart is located on the face, the use of scrubs, drying cosmetic masks, alcohol lotions, dermabrasion or facial peeling, facial massage is not recommended.
Frequent injury to the threadlike wart, the danger of the spread of the virus and the emergence of new formations, as well as the patient’s desire to get rid of the wart as a cosmetic defect, are indications for removing the wart. To prevent the spread of HPV through the body, removal must be combined with a course of antiviral therapy.
Surgical excision of the wart can lead to scar formation. Given the localization on the face, the small size and the benign nature of the formation, this method of removal is practically not used. Cryodestruction of the wart is carried out with liquid nitrogen, after which a crust forms in its place. It is important not to injure it and wait until it disappears on its own, then there will be no scar left at the removal site. Removal of the threadlike wart can be carried out using electrocoagulation or radio wave method. One of the best ways is to remove warts with a laser, which does not leave a noticeable trace of removal and prevents the spread of the virus to surrounding tissues.