Filiform Wart

Filiform wart is an elongated, thin, flesh-colored, and non-malignant growth in skin. The skin outgrowths are shaped unusually like filiform protrusions and hence the name. It is caused due to infection by the HPV or human papilloma virus.

Filiform warts usually form on the face, specifically on the eyelids, lips, and neck. They may also develop on the legs or other auxiliary parts of the body. They are harmless, painless, and do not cause distress or discomfort. The warts are however very contagious and ghastly in appearance.

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Filiform warts may be treated and surgically removed to prevent spread of the infections as well as for cosmetic purposes.

Symptoms of filiform wart

A few common signs and symptoms of filiform warts are mentioned below:

  • The skin growth usually looks like a brush
  • In some cases, a filiform wart may be unusually long
  • The warts can form in varied parts of the body, but are more prevalent on the face. They are therefore also known as facial warts. In most cases, filiform warts usually occur on the eyelids, nose, lips, and/or neck.
  • Filiform warts and causative infection are prone to spreading to other areas of the body
  • They are typically darker in color than surrounding skin. Facial filiform warts are however the of normal skin/flesh color.
  • They are benign and normally do not cause any pain
  • The skin areas next to the affected site may be very itchy. Advancement in the intensity of the underlying HPV infection and/or migration of the infection to other areas of the body can worsen the itchiness.
  • If filiform warts develop in areas with skin folds or those prone to rubbing or friction, then there may be soreness and increased irritation at the site.
  • In some instances, there may be some bleeding. It is more prevalent when the warts are at an advanced phase.
    • Spread and increased strength of infection prevent proper healing of the skin, thereby triggering the formation of tears and cuts at the site. Such breaks on skin may bleed and lead to other health problems.

Causes

Filiform wart is caused due to infection by HPV virus strains 1, 2, 29, 4, and 27. Infection by HPV causes swift maturation and damage of skin’s top layer, which then lays the foundation for formation of the abnormal growths on skin. The warts tend to grow and thrive in warm, moist, and sweaty areas of the body.

Filiform warts are very contagious. They may pose increased risk of new infection or spread in the below listed ways:

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  • Simply touching a filiform wart can result in transmission of infection
  • Patient may help spread the infection on his/her own body by touching the affected site and then touching an area with healthy skin.
  • Presence of bruises, tears, breaks, or cuts on skin makes its more vulnerable to infection by HPV virus
  • An impaired immune system increases risk to HPV infection
  • The virus tends to grow and multiply in skin areas with warm and moist environments
  • Sharing towels, soaps, and other items of personal hygiene with a patient can help transmit the infection
  • Sharing clothes, especially those which have been used by a person with filiform warts, can increase the risk of transmission
  • A patient may transfer the virus to inanimate objects like door knobs, shower floors, or areas around swimming pool, etc. Exposure or contact with such infected places or objects can help spread the infection, thus increasing risk to development of filiform warts.

Treatment of filiform wart and removal

Filiform wart can be treated in the following ways:

  • HPV vaccine: It can help prevent the infection in healthy people.
  • Application of salicylic acid on filiform wart and adjacent skin: Salicylic acid irritates and inflames the skin, thereby producing a response by the immune system. The white blood cells fight the irritation/inflammation as well as the underlying viral infection. The acid needs to be applied several times over the course of many days. This can cause skin damage and hence is not used for treatment of warts on areas with fragile skin.
  • Surgery: The wart may be surgically removed by a doctor with a scalpel, electric needle, or some other surgical tool. The size of scarring is dependent on the size of the skin growth.
  • Cryosurgery: Filiform wart is frozen with liquid nitrogen and subsequently removed. The blistered site is then bandaged to avoid secondary infection. One to four sessions of cryotherapy may be needed to completely eliminate the growths.
  • Cantharidin: This treatment is like cryosurgery, but less cold, and requires topical application of medicine that causes the affected site to blister. The dead/withered tissue is removed by doctor after the blister has dried.
  • Laser surgery: A laser beam is directly applied on the filiform wart to destroy it. Laser surgery is expensive. Hence, doctors may suggest this option as the last resort if other methods do not yield desired results.
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