Treatment of Warts in Children With Focus on Recalcitrant Warts: A Narrative Review

Abstract

Context: Warts are benign cutaneous and mucosal growths caused by human papillomavirus. Warts are the most common skin diseases seen by pediatric dermatologists. Warts are often self-limited, especially in children, but some lesions are not resolved despite repeated treatments and referred to as recalcitrant warts.  Evidence acquisition: Electronic databases such as Google Scholar, PubMed, and Scopus were searched during 2000-2018 and a review was conducted for articles published in English on pediatric warts by focusing on recalcitrant warts. Results: If warts are asymptomatic and being in a location that causes no cosmetic or other problems, observation is the ideal management course. Most parents and children prefer treatment for their warts. There are three modalities of treatment: medical, surgical, and immunotherapy. Conclusions: Treatment of warts is a therapeutic challenge that depends on the patient’s age and the type of warts. Despite treatment according to evidence-based guidelines, a significant proportion of warts are failed to respond. This condition is an unsolved problem in practice. The management for treating these lesions has remained unclear and a wide range of the second line of treatments has been developed.