Treatment Modalities of Cutaneous and Genital Warts: A Narrative Review

Abstract

Human Papillomavirus (HPV) are non enveloped Deoxyribonucleic Acid (DNA) viruses, sized between 50-55 nm, that form two distinct groups to cause epithelial proliferation at cutaneous and mucosal surfaces, which are mostly benign. With more than 100 different HPV types, estimated 30-40 strains affect human genital tract. Of which, 16, 18, 31, 33, 35, 39, 45, 51, 52, and 5 are the oncogenic (high-risk) types associated with cervical, vulvar, vaginal, and anal cancers, and 6, 11, 40, 42, 43, 44, and 54 are non oncogenic (low-risk) types and are associated with genital warts. HPV 6 and 11 are more commonly associated with genital warts and are also responsible for approximately 90% of these lesions. Despite a series of modalities available to treat HPV, that range from topical to immunotherapeutic modalities to surgically destructive procedures, there is no promising, stand-alone modality which still is a cause of dilemma for Dermatologists while treating warts. The present article reviews all the treatment modalities commonly applied in practice and also the areas less explored by their level of evidences.