Evidence-based review of management of nongenital cutaneous warts

Human papillomavirus (HPV)-induced tumors of the skin are often varied in clinical presentation, ranging from benign warts to malignant neoplasms. This article reviews the natural history and recommended treatment of some of the common HPV-induced tumors, as well as reviews many of the clinical trials for future wart therapies. This review is not meant to serve as a guideline or to be all-inclusive. Almost invariably, HPV-associated diseases are difficult to treat. The treatment options employed by healthcare professionals are usually dependent on their prior experience or exposure during residency. Many wart treatments are based on anecdotal evidence rather than on carefully conducted clinical trials. A systematic review of the literature was performed using the 1966-April 2002 MEDLINE database, the 1967-2000 PubMed database (National Library of Medicine), and the Cochrane Database of Systematic Reviews. Randomized clinical trials, controlled clinical trials, and multicenter studies were reviewed. Articles were included in the evaluation if they were printed in English, reported on human subjects, and analyzed subjects who had cutaneous nongenital warts.