The Protean Manifestations of Human Papillomavirus Infection: New Facies of an Old Foe: A Clinical Perspective

CUTANEOUS WARTS are one of the most common maladies treated by the clinical dermatologist. Although all types of warts represent a therapeutic challenge, plantar warts remain a particular vexation. Often unresponsive to therapy, a variety of therapeutic techniques have been used to assault this often implacable foe. Clinicians, after decades of observation, have classified plantar warts into a variety of types: deep (myrmecia), common, mosaic, and endophytic. Molecular studies have revealed that different clinical varieties of warts are associated with specific human papillomavirus (HPV) types. The following HPV types are associated with their respective clinical entities: HPV-1 with deep plantar warts, HPV-2 and HPV-4 with common and mosaic warts, and HPV-4 with endophytic warts. 1 More recently, two new HPV types have been associated with plantar warts: HPV-65 which has been associated with a pigmented verrucous plantar wart, and HPV-63 which has been associated with whitish, punctate, keratotic warts showing