Article Figures & Data
Tables
- Table 1
Baseline Characteristics of the Children With Warts Included in the Follow-up (n = 333)
Characteristic Value Age, median, y 8 (4–12) Sex, No. (%) Male 162 (49) Female 171 (51) Skin type, No. (%) Caucasian 284 (85) Non-Caucasian 49 (15) School, No. (%) School A, 28 classes 219 (66) School C, 8 classes 27 (8) School D, 12 classes 87 (26) Type of warts, No. (%) Common only 100 (30) Plantar only 192 (58) Both 41 (12) Number of warts, No. (%) 1 wart 191 (57) 2 warts 63 (19) 3–5 warts 52 (16) ≥6 warts 27 (8) Presence of warts ≥1 cm, No. (%) No 209 (63) Yes 124 (37) - Table 2
Univariate Associations of Demographic and Wart Factors at Baseline With the Resolution of All Warts
Potential Risk Factor No. of Cases/Person-Years Resolution Rate per 100 Person-Years HR (95% CI)a P Value Demographic factors Age in years 8–12 80/176 45 1.0 (ref) 4–7 82/137 60 1.5 (1.1–2.0) .02 Age, per year decrease – – 1.12 (1.04–1.20) .003 Sex Female 76/164 46 1.0 (ref) Male 86/149 58 1.3 (0.9–1.7) .13 Skin type Caucasian 129/274 47 1.0 (ref) Non-Caucasian 33/39 85 2.0 (1.3–2.9) .001 Wart factors Type Common only 50/94 53 1.0 (ref) Plantar only 96/181 53 1.0 (0.7–1.4) .88 Both 16/38 42 0.7 (0.4–1.2) .19 Number Single 90/184 49 1.0 (ref) Multiple 72/129 56 1.1 (0.8–1.4) .71 Number, per additional wart – – 1.03 (0.96–1.10) .43 Size ≥1 cm 55/117 47 1.0 (ref) <1 cm 106/194 55 1.2 (0.9–1.6) .29 -
HR=hazard ratio; ref=reference group.
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↵a Generated by univariate Cox proportional hazards model.
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Inconvenience and Treatment No. (%) Any inconvenience caused by warts 73 (26) Pain 23 (8) Irritation 28 (10) Unsightly appearance 38 (14) Bothered by opinion of others 10 (4) Initiated treatment 106 (38) OTC treatment only 49 (18) Family physician treatment only 41 (15) Both 16 (5) Specific OTC treatmentsb Dimethylether/propane cryotherapy 28 (10) Low-dose (17%) salicylic acid 37 (13) Duct tape 2 (1) Other 12 (4) Family physician treatmentsc Liquid nitrogen cryotherapy 49 (18) High-dose (40%–50%) salicylic acid 14 (5) Other 3 (1) -
OTC=over the counter.
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↵a Response to parental questionnaires was 276 of 333 (83%).
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↵b Initiated treatments were comparable for common warts and plantar warts.
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↵c More than 1 option possible: 23 children reported more than 1 type of inconvenience, 13 children used more than 1 OTC treatment, and 9 children used more than 1 family physician treatment.
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- Table 4
Univariate Associations of Demographic and Wart Factors at Baseline and Inconvenience With the Decision to Treat Warts (n = 276)
Factor OR (95% CI)a P Value Demographic factors Age (per year increase in age) 1.1 (0.9–1.2) .33 Female sex 1.3 (0.8–2.1) .28 Caucasian skin type 1.6 (0.8–3.2) .24 Wart factors Plantar location 1.1 (0.7–2.0) .66 Number (per additional wart) 1.1 (1.0–1.2) .08 Size ≥1 cm 3.2 (1.9–5.3) <.001 Warts not resolved at follow-upb 2.0 (1.2–3.3) .01 Inconvenience caused by wartsc Yes 38 (16–90) <.001 Type of inconvenienced 11 (5.6–23) <.001 Pain 21 (4.8–91) <.001 Irritation 27 (6.3–118) <.001 Unsightly appearance 20 (6.7–57) <.001 Opinion of others 16 (2.0–126) .01
Additional Files
The Article in Brief
Natural Course of Cutaneous Warts Among Primary Schoolchildren: A Prospective Cohort Study
Sjoerd C. Bruggink , and colleagues
Background Because cutaneous warts resolve spontaneously and available treatments often fail, family physicians and patients may consider a wait-and-see policy. This study examines the natural course of cutaneous warts among primary schoolchildren and decisions about their treatment.
What This Study Found In this study of 1,099 Dutch children aged 4 to 12 years, 33 percent of children had cutaneous warts at baseline. One-half of children with warts were free of warts 1 year later despite any treatment. Resolution rates were higher among younger children and children with non-Caucasian skin type. During the 15 month follow-up, 38 percent of children and their parents decided to treat the warts, a decision that was more likely when warts were bigger and bothersome. Eighteen percent used over-the counter treatment only, 15 percent used a family physician-provided treatment only, and 5 percent used both.
Implications
- These findings may be useful in shared decision making with parents and children. The authors suggest that parents and family physicians should weigh the benign natural course, adverse effects of treatments, and costs on the one hand, and the effectiveness of treatments and risk of spreading untreated warts on the other.
