Treatment.
—A simple excision of the growth with its base is all that is needed in these cases.
Warts; Verrucæ.
—These constitute one variety of papillomas, the overgrowth having its original site in the prickle-cell layer of the rete. The most common form occurs upon young subjects on the exposed parts, as the face, hands, and feet. These are usually multiple; they frequently occur upon the surface, and retain dirt in such a manner as to be nearly always recognizable on the surrounding skin. They frequently disappear with as little known reason as that which caused their appearance.
Dilated papillary growths, like a fringe, are sometimes seen about the face and neck of elderly people. These have been known as filiform warts, while Unna gave them the name fibrokeratomas.
A form described as the seborrheic wart occurs upon the face and elsewhere in elderly people. It is frequently pigmented, may itch intolerably, and is perhaps the form which most often undergoes malignant degeneration. To the acuminate form of wart, which is usually soft, and most often met with as a venereal wart about the genital region, has been given the name condyloma. These appear in either sex, grow rapidly, are covered with a puruloid secretion, bleed easily, and assume often such shape and resemblance as to give rise to expressions “strawberry growth,” “raspberry growth,” etc. They are always produced by irritation, usually in connection with one of the venereal diseases, and are generally due to lack of cleanliness. They may grow luxuriantly and over a considerable area, and, when appearing on the surface of the vulva, conceal completely the parts underneath. They also occur in connection with the mucous patches of tertiary or hereditary syphilis, but have essentially the same structure, no matter how produced.
Treatment.
—In the treatment of ordinary warts nothing is better than absolute cleanliness. A dry wart touched daily with formalin solution, or covered with collodion containing 1 to 2 per cent. of corrosive sublimate, will usually shrink and become detached in a few days. Thorough excision of any true wart is sufficient to finally dispose of it. If the wart be cut through it is likely to bleed profusely, since its vessels are larger than those of the surrounding skin. Any growth of this kind can also be destroyed by the actual cautery, or by one of the strong caustic agents, which, however, should be used with great care.
Venereal warts, condylomas, are best treated radically, either with the actual cautery or with scissors and sharp spoon. Local anesthesia is always advisable in order that this may be thoroughly done. In instances of extensive growths of this kind a general anesthetic may be profitably given.