Differential Diagnosis for Wart in a Pediatric Patient
Single Most Likely Diagnosis
- Verruca vulgaris (Common Wart): This is the most common type of wart and is highly likely in a pediatric patient due to its prevalence and the fact that children are often exposed to the human papillomavirus (HPV) that causes it.
Other Likely Diagnoses
- Molluscum contagiosum: A viral skin infection that causes small, pearly, or flesh-colored bumps, often seen in children. It's contagious and can be spread by skin-to-skin contact or through contaminated objects.
- Verruca plana (Flat Wart): These are flat-topped, smooth warts that can appear in a line due to scratching or shaving. They are common in children and can be caused by HPV types 3,10,28, and 49.
- Verruca plantaris (Plantar Wart): A wart on the sole of the foot, which can be painful. It's caused by HPV and can be spread through direct contact with an infected person or by walking barefoot on contaminated surfaces.
Do Not Miss Diagnoses
- Squamous Cell Carcinoma (SCC): Although rare in children, SCC can sometimes present as a wart-like lesion. It's crucial to consider this diagnosis, especially if the lesion is non-responsive to treatment, grows rapidly, or has an unusual appearance.
- Keratoacanthoma: A low-grade, or sometimes considered benign, tumor that can resemble a wart but has a more rapid growth phase. It's essential to distinguish it from SCC due to its different management and prognosis.
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 Epidermal Hyperplasia (FEH): Also known as tree man syndrome, it's an extremely rare condition caused by HPV types 5 and 8, leading to an abnormal growth of skin that resembles tree bark. It's more common in certain geographic areas and can be disfiguring if not managed properly.