Periungual warts
Presentation
Small, pinhead lesions develop
around the fingernails and
toenails but over the weeks
grow to form rough, raised
lesions that may affect nail
growth (Figure 9) and
sometimes cause permanent
deformity of the nail. Because
the highly infectious virus
gains access through cuts and
abrasions, nail biters and those
that pick and tear at their nails
are particularly susceptible.
Some warts will grow to form
large cauliflower-like lesions
(Figure 10) that may
occasionally give cause for
concern (Warts Information
Center, 2012). The patient in
Figure 10 was known to have
acquired genital HPV probably
type 16 or 18, which carries a
risk of malignant change. A
biopsy of the lesion was
therefore arranged to exclude
such a problem. HPV could
have been transmitted by hand
contact with the genital area.