Flat warts is a benign skin formation, which is a flat nodule up to 5 mm in size, slightly rising above the surface of the skin. Disease, as a rule, are multiple and are located in groups on the face, back of the hands, shins. The diagnosis is based on a visual examination of the formation and is confirmed by a histological examination of the removed wart. Treatment consists in their removal with liquid nitrogen, electrocoagulation, radio wave method or using a laser.
Flat warts are benign skin neoplasms that are not inclined to malignant transformation. They are quite rare and account for about 4% of all warts. Most often, flat warts are observed in young people and children. For this reason, they got their second name — youth. Dermatology deals with the diagnosis and treatment of flat warts.
Like other types of warts, as well as papilloma and condylomas, flat warts are the result of human infection with the papilloma virus (HPV). The virus is transmitted from person to person by contact through direct contact during handshakes, hugs or through a kiss, as well as indirectly through handrails and railings, door handles, elevator buttons, library books, various common items, etc.
HPV infection occurs through minor injuries (cuts, scratches) on the skin or mucous membranes. From the surface layers of the skin, the virus penetrates into the human body, persists in the nervous system and remains there almost forever. At the same time, HPV may not manifest clinically for a long time. The appearance of flat warts is associated with the active reproduction of the virus in the skin, leading to its local proliferation. Activation of the virus can be caused by a decrease in general immunity, fright, emotional stress, chronic stressful situations.
The constant presence of HPV in the human body causes frequent recurrence of a flat wart after its removal. In addition, when a wart is injured or its inadequate treatment, HPV self-infection may occur and the process spreads to healthy areas of the skin with the appearance of new flat warts on them.
A flat wart is a papule (nodule) with a flat top slightly rising above the general surface of the skin, having a rounded or irregular shape. A flat wart has clear borders and a smooth surface. A distinctive feature is the absence of processes of keratinization of the skin in the area of the wart, so that its surface remains smooth and shiny, without the formation of any outgrowths. The color of a flat wart varies from the color of healthy skin to pink or light brown, the size does not exceed 5 mm. The absence of a skin pattern on the surface of the wart is characteristic.
Usually flat warts appear in groups of several elements separated from each other, not prone to fusion. Their typical localization is the skin of the face (most often the chin and forehead), the back surface of the hands, the lower legs. The appearance of flat warts is not associated with any unpleasant sensations. However, they represent a noticeable cosmetic defect, and therefore can cause psychological discomfort in the patient, especially when warts are located on the face. In some cases, there is a slight itching in the area of warts.
The dermatologist establishes the diagnosis of a flat wart by a thorough visual examination and additional dermatoscopy of the formation. Histological examination of the wart tissues after its removal allows us to confirm the diagnosis with 100% accuracy. A PCR study is conducted to identify the HPV infection of the patient. In terms of oncological alertness, patients with warts are recommended to be examined for HPV of high carcinogenic risk.
Differential diagnosis of a flat wart is carried out mainly with other types of warts. A flat wart differs from an ordinary wart by a smaller size and a flat surface, from a filiform warts by the absence of growths, from a plantar wart by another localization.
Quite often, spontaneous disappearance of flat warts is noted. In addition, due to their shape, they are rarely injured. Therefore, the removal of a flat wart is mainly due to the patient’s desire to get rid of it as a cosmetic defect.
There are many folk recipes for the treatment of flat warts. However, self-medication is fraught with the development of complications, the spread of the human papillomavirus through the body and the appearance of new warts. When deciding to remove a flat wart, it is best to seek help from a dermatologist. The doctor will select the most optimal method of treatment, if necessary, prescribe an antiviral course of HPV therapy.
Given the frequent location of flat warts on the face, it should be immediately noted that surgical excision or electrocoagulation is not suitable for their removal, since these methods of treatment often lead to the formation of scars at the site of removal. Cryodestruction of the wart is associated with the danger of too deep freezing of tissues, after which a scar may also remain.
The most effective methods that give a good cosmetic result are radio wave removal and their removal of warts by laser. Their use makes it possible to produce an optimal depth of exposure and ensures simultaneous coagulation of blood vessels, which prevents the spread of the virus.
Complications of the removal of flat warts include: burns, scarring, incomplete removal of the wart, leading to its proliferation. The use of modern methods of removal, professionalism and experience of the doctor. Performing treatment, reduce the possibility of complications to a minimum. The only thing that no method of treating a flat wart can guarantee is the absence of its recurrence after removal. This is due to the constant presence of HPV in the body. Removal of warts against the background of antiviral therapy promotes the transition of the virus to a latent state and reduces the risk of relapse.