Differential Diagnosis for Warts on Hand/Fingers
Single Most Likely Diagnosis
- Common Warts (Verruca Vulgaris): This is the most likely diagnosis given the patient's age, location of the warts (hand/fingers), and the fact that they have had them for a few years. Common warts are caused by the Human Papillomavirus (HPV) and are often found on the hands and fingers.
Other Likely Diagnoses
- Flat Warts (Verruca Plana): Although less common on the hands, flat warts could be considered, especially if the lesions are flat and smooth.
- Plantar Warts (Verruca Plantaris): While typically found on the soles of the feet, it's possible for plantar warts to appear on the hands, especially if the patient has been in contact with the virus in this area.
- Molluscum Contagiosum: This is a viral skin infection that causes small, pearly, or flesh-colored bumps. It's contagious and could be considered if the lesions have a characteristic appearance and the patient has been in close contact with others who may have the infection.
Do Not Miss Diagnoses
- Squamous Cell Carcinoma: Although rare, especially in a young patient, it's crucial not to miss a potential skin cancer. If any of the warts have changed in size, shape, color, or have started to bleed, this diagnosis must be considered.
- Keratoacanthoma: A low-grade malignancy that can resemble a wart. It typically grows quickly and can resolve on its own, but it's essential to distinguish it from squamous cell carcinoma.
Rare Diagnoses
- Epidermodysplasia Verruciformis: A rare genetic disorder characterized by an abnormal susceptibility to HPV infections, leading to the development of multiple types of skin lesions, including warts.
- Focal Dermal Hypoplasia (Goltz Syndrome): A rare genetic disorder that affects the development of the skin, bones, and other tissues. Skin lesions can resemble warts but are usually present at birth or appear early in life.