What causes cutaneous viral warts?
Warts are due to infection by the human papillomavirus (HPV), a double-stranded DNA virus. There are more than 150 known HPV types, only some of which infect the skin, giving rise to a variety of clinical presentations. Infection begins in the basal layer of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis, and production of infectious virus particles — the wart.
HPV is spread by direct skin-to-skin contact or autoinoculation; if a wart is scratched or picked, a wart may develop under the fingernail (subungual wart) or virus may be spread to another area of skin.
Radiowave Surgery
In the past, the only way to remove them was by surgery – cutting the skin. However, moles, warts and other skin lesions can now be removed easily with minimal risk of scarring, using a revolutionary method known as radiosurgery.
Radiowave Surgery works on the principle of using tissue as resistance against high-frequency radio waves delivered at low temperatures.
When a high-frequency wave passes through, the tissue resists its passage, thereby creating heat. This heat increases the inner pressure within the mass of tissue by taking the intracellular water to way above boiling point. The increased pressure makes cell walls break, creating the cutting effect.
As the water in the intracellular tissue vaporises, the heat spreads, coagulating tissue proteins, which in turn brings about haemostasis or stoppage of blood flow, without actually having to burn the tissue as is generally required during such surgery.
A variety of electrodes are used depending on the type of lesion, e.g. fine needle, wire loop or scalpel blade, among others. We will then use freeze post removal as the last part of the treatment.
Filiform warts
A filiform wart is a cluster of fine fronds emerging from a narrow pedicle base usually found on the face. They are also described as digitate (finger-like).
How is a cutaneous viral wart diagnosed?
Cutaneous viral warts are usually diagnosed clinically. Clinical clues to diagnosis can include:
- Pinpoint red or black dots (papillary capillaries) are revealed when the wart is pared down. Patent capillaries cause pinpoint bleeding. Plantar corns lack the papillary capillaries.
- Location of a plantar wart is not restricted to pressure sites whereas a plantar callus or corn is always at a pressure site.
- Tenderness is maximal with lateral pressure for a plantar wart whereas a corn or callus is more tender with direct pressure.
We use Dermoscopy to assist visualisation of the papillary capillaries of a viral wart, and can distinguish other verrucous lesions such as a seborrhoeickeratosis.
Prices
Thermavein ( repeat sessions required 4 weeks apart ). Usually approx 3 sessions for complete removal . Each patient varies. £125 per session.
Complete excision using Ellman radio wave surgery £400