dermatologic disorders
Warts
Diagnosis of Warts
Clinical evaluation Rarely biopsy Diagnosis of warts is based on clinical appearance; biopsy is rarely needed. A cardinal sign of warts is the absence of skin lines crossing their surface and the presence of pinpoint black dots (thrombosed capillaries) or bleeding when warts are shaved. Shaving is typically done without anesthesia. If necessary, confirm the diagnosis of a wart by shaving its surface to reveal thrombosed capillaries in the form of black dots. Differential diagnosisof warts includes the following: Calluses and Corns (clavi): May obscure skin lines but do not have thrombosed capillaries when shaved Lichen Planus : May mimic flat warts but may be accompanied by lacy oral lesions and Wickham striae and may be symmetrically distributed Seborrheic Keratoses : May appear more stuck on, be pigmented, and include keratin-filled horn cysts Skin Tags (achrocordon): May be pedunculated and smoother and more skin-colored than warts Squamous Cell Carcinoma : May be ulcerated, persistent, and grow irregularly DNA typing of the virus is available in some medical centers but is generally not needed. 