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Plantar warts, flat warts, and HPV
A large percentage or people show evidence of prior HPV infection particularly with the HPV types which commonly cause warts.
Br J Dermatol 1998 May;138(5):840-5:
The prevalence of common skin conditions in Australian school students: 1. Common, plane and plantar viral warts.
Kilkenny M, Merlin K, Young R, Marks R University of Melbourne, Department of Medicine (Dermatology), St Vincent's Hospital, Victoria, Australia.
"Although viral warts are common, their exact frequency in the community is often underestimated and not well recorded. A random sample of 2491 students from schools throughout the State of Victoria, Australia were examined by dermatologists and dermatology registrars to record the prevalence of common, plantar and plane warts.
The overall prevalence of warts adjusted for the age and sex of Victorian school children was 22% (95% confidence interval (CI) 20.1-20.7) varying from 12% (95% CI 9.4-15.7) in 4-6 year olds to 24% (95% CI 18.3-30.4) in 16-18 year olds. Common warts were the most frequent (16%) compared with plantar warts (6%) and plane warts (2%). There was no difference in the overall frequency of warts between males and females and there was no difference in frequency between those who had eczema and those who did not. Almost 40% of those found to have warts on examination had indicated on the survey questionnaire that they did not have any of these lesions. Of those who knew that they had warts, only 38% had used any treatment for them. These data, the first community-based prevalence data on warts ever published from Australia, confirm that warts are indeed common. They suggest the need for education programs in schools on the nature of these lesions and the treatment available."
Epidemiol Infect 1988 Dec;101(3):537-46:
A study of HPV 1, 2 and 4 antibody prevalence in patients presenting for treatment with cutaneous warts to general practitioners in N. Ireland.
Steele K, Shirodaria PV, Pfister H, Pollock B, Fuchs P, Merrett JD, Irwin WG, Simpson DI Department of General Practice, Queen's University of Belfast.
"Three hundred and seventy-six patients attending their general practitioner with cutaneous warts at five health centers in Northern Ireland were screened for human papilloma virus (HPV) types 1 and 2 IgM antibody using an indirect immunofluorescence test. Eight-eight (23.4%) patients were positive for HPV type 1 IgM and 156 (41.5%) for HPV type 2 IgM. HPV 1 IgM antibody was significantly more likely to be associated with plantar warts than warts elsewhere (P less than 0.0001). HPV 2 IgM was present in 45 (34.1%) patients with plantar warts and 99 (45.6%) patients with warts at other sites (P = 0.1).
Evidence of multiple infection by HPV types 1 and 2 was demonstrated by the finding of HPV 1 and 2 IgM antibodies in the sera of 16 (4.3%). HPV 4 was found in only 1 out of 30 biopsies and HPV 4 IgM was undetectable in 50 randomly chosen sera."
Plantar warts should be treated in the same manner as genital warts.