From the Guidelines
Verruca vulgaris lesions, regardless of their size, do not have a reported rate of malignancy, as stated in the study 1. The study 1 discusses various types of lesions, including oral squamous papilloma, verruca vulgaris, and condyloma acuminatum, and notes that malignant transformation has not been reported in verrucae. Key points to consider include:
- Verruca vulgaris is caused by low-risk types of HPV, such as genotypes 6 and 11, which are not associated with malignancy 1.
- The size and appearance of the lesion do not correlate with malignant potential, as large warts exceeding 2 cm in diameter and raised more than 1 cm are still benign.
- Treatment options for large warts include cryotherapy, salicylic acid preparations, surgical excision, laser therapy, or immunotherapy, depending on the location, patient preference, and previous treatment responses.
- It is essential to evaluate any rapidly growing, bleeding, or changing lesion that appears wart-like to rule out other conditions that may mimic warts but carry malignant potential. The primary concern with large verruca vulgaris lesions is their potential impact on quality of life, particularly if they are cosmetically concerning, painful, or functionally limiting, rather than their risk of malignancy.
From the Research
Verruca Vulgaris Lesions
- The provided studies do not specifically address the rate of malignancy for verruca vulgaris lesions greater than 2 cm in diameter and raised greater than 1 cm.
- However, it is mentioned in 2 that verruco-papillary lesions of the oral cavity, which include verruca vulgaris, are mostly slow growing and benign in nature, with a viral etiology.
- The study 3 presents a case of a verruca vulgaris-associated cutaneous horn, but does not provide information on the malignancy rate of such lesions.
- Studies 4, 5, and 6 discuss the treatment of verruca vulgaris lesions using various methods, including imiquimod and pulsed dye laser therapy, but do not address the malignancy rate.
Malignancy Risk
- The available evidence does not provide a clear answer to the question of the rate of malignancy for verruca vulgaris lesions greater than 2 cm in diameter and raised greater than 1 cm.
- It is essential to note that verruca vulgaris is generally considered a benign lesion, but there may be cases where it is associated with malignant transformations, as mentioned in 2.
- Further research is needed to determine the malignancy risk of verruca vulgaris lesions with specific characteristics, such as size and height.