| Warts are common on the hand. They are thought to be due
to viral mediated intradermal hyperkeratosis. Most warts involute spontaneously over an average
of a two year lifespan, and are considered chronic after two years.
Many treatment options exist, including topical irritants, oral cimetidine,
electrofulguration, laser cauterization, cryosurgery and surgical excision. The proliferative process is intradermal, and local treatment
with curettage under local anesthesia is often effective. This is a useful option for recalcitrant
warts which either involve the eponychial fold or are mutifocal and confluent and is an alternative
to excision and resurfacing with a skin graft or local flap. Curettage is also appropriate treatment
for pyogenic granuloma. The following case illustrates treatment
of a chronic palmar wart with curettage.
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