Recurrent Subungual Viral Warts

Abstract

Warts, cutaneous manifestations of human papillomavirus infection, are difficult to cure. Warts have a high recurrence rate and there is no known single completely effective treatment. In this case, a 14-year-old boy presented with a subungual wart of the thumb that did not respond to salicylic acid. Excision was performed due to discomfort caused by pain and deformation of the nail plate. After the first operation, the patient had to receive two revision operations due to recurrence. Epithelialization was completed 2 weeks after the second revision surgery, after which there was no recurrence. According to literature review, many immunocompetent patients can expect spontaneous recovery without any treatment. If treatment is necessary, salicylic acid and cryotherapy have the strongest evidence of efficacy and are recommended as first-line treatments. Various other treatments are used alone or in combination. During surgical removal, special attention should be given for complete removal of the wart to prevent recurrence.