Children with Warts: A Retrospective Study in an Outpatient Setting
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Published on: November 8, 2024
Anne M Kuwabara1, Barbara M Rainer1, Hatice Basdag1
1Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Insights
Common warts in children often resolve within 4 years, irrespective of treatment. Factors like prior infections or multiple sites may prolong resolution time, guiding management decisions.
Area of Science:
- Pediatric Dermatology
- Clinical Epidemiology
Background:
- Common warts (verrucae) are frequent in pediatric populations.
- Understanding their natural course and influencing factors is crucial for effective management.
Purpose of the Study:
- To investigate the demographics and clinical course of common warts in children.
- To identify factors associated with wart resolution time in a pediatric outpatient setting.
Main Methods:
- Retrospective chart review and telephone survey of children (0-17 years) diagnosed with warts.
- Analysis of management strategies, time to resolution, and associated patient/wart characteristics.
Main Results:
- Hands and head/neck were the most common sites affected by warts.
- Most children received therapy, but treatment did not consistently alter the resolution course.
- History of childhood infections and multiple affected sites were linked to longer resolution times.
Conclusions:
- Warts resolved in 65% of children by 2 years and 80% by 4 years, largely independent of treatment.
- Counseling and conservative management may be appropriate for most pediatric warts, avoiding aggressive treatments.
- Findings support shared decision-making between clinicians, children, and parents regarding wart management.
Background:
The purpose is to investigate the demographics and course of common warts in children in an outpatient setting.
Methods:
A retrospective medical chart review and telephone survey study were completed on an outpatient cohort of children (0-17 yrs) with a clinical diagnosis of warts at a single-center, university-based pediatric dermatology practice. The main outcome measures included management, time to resolution, and associated factors of warts in children.
Results:
Of the 254 patients we contacted, 214 agreed to participate in the survey. The most commonly involved sites were the hands and the head and neck area. Most children received some form of therapy, but it is unclear that any form of treatment altered the course. However, children with a medical history of childhood infections or more than one anatomic site had significantly greater risk of having a longer time to resolution.
Conclusion:
Warts resolved in 65% of children by 2 years and in 80% within 4 years, regardless of treatment. With the exception of a history of childhood infections and having more than one anatomic site, time to resolution was not altered by wart or patient characteristics. Thus counseling without aggressive destructive treatment is a reasonable approach to managing warts in most children. Our findings will provide guidance in the process of shared decision making with parents and children.
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