Periungual Warts also known as Nail Warts or Fingernail Warts is caused by human papillomavirus (HPV). HPV can enter the skin through a cut or scrape. They are cluster around the nails (fingernail or toenail). They appear as thickened, fissured, cauliflower like skin around the nails. Nail biting increases susceptibility to these warts.

At first they are about the size of a pinhead smooth, shiny and virtually impossible to spot. But after a week or months they grow to the size of a pea and have rough, irregular bumps that can affect nail. In the most severe cases nail can be permanently deformed and this can lead to fungal infection

RISK FACTORS

  • Various risk factors for periungual warts include:
  • Periungual warts affect children and young adults,especially if they are nail biters as HPV enters the skin through cuts or scrapes. These warts are difficult to treat.
  • Those who pick nail cuticles frequently. 
  • People with compromised immune system are at higher risk of developing periungual warts and if they develop it then its very hard to treat the warts.
  • In cases of atopic dermatitis due to scratching the HPV can enter the skin.
  • Using clothes and towels of an infected person can also give you HPV and warts would develop.
  • Those who work in water for long in public places are more susceptible to catch infection.
  • Those who don't maintain hygiene are also at increased risk.

COMPLICATIONS

If periungual warts are not treated they may cause permanent damage to the skin and nails. The nails may get deformed permanently.

Further infection may also be seen in soft tissues and surrounding areas.

SYMPTOMS AND CAUSE

SYMPTOMS

  • The periungual warts are rough grainy bumps around and under the nail. They are usually small bumps around the toenails or fingernails.
  • Periungual warts also lead to loss of cuticle and increase the risk of self tissue infection. 
  • They are usually skin-toned ,pink,tan or white.Small warts are usually painless but when they increase in size then they develop pain
  • Periungual warts hinder with the nail growth causing split nails.
  • The cuticles are also deformed

CAUSES

  • Periungual warts caused by the HPV (the human papillomavirus). This virus can be present in many people without showing any indication of a warts.
  • Periungual warts found in persons who pick and bite their nails.Broken skin allows easy entry for the virus. 
  • Periungual warts often cause loss of the cuticle and paronychia. These kind of warts cause damage to the nail by lifting the nail from the skin or causing the nail to partially detach.
  • HPV is found on surface of things used by an infected person so if someone else comes in contact with the surface they also contract the infection.

DIAGNOSIS AND TREATMENT

DIAGNOSIS

Visual appearance and the location is enough for diagnosing a case of perungual warts as periungual warts develop around the finger and toenails.They appear as thickened,fissured cauliflower-like skin around the nail plate. They can cause discomfort or pain and may disrupt nail growth.

In case of doubt scrapings of the hyperkeratotic area can be sent for evaluation.

TREATMENT

Conventional treatment for periungual warts include salicylic acid, cryotherapy, laser therapy, surgical removal, antigen injections but theses treatments are not permanent as they can regrow and come back in more fierce form. 

Thus homeopathic treatment is best treatment for periungual warts.

MANAGEMENT

  • Periungual warts are contagious and can infect even during the course of treatment. Following steps would help with the cases of periungual warts:
  • Patient should be advised to maintain hygiene and wash hands regularly.
  • Don't touch warts of other people.
  • keep your personal items like nail clipper, towels, clothes separately.
  • Wear protective gloves while working especially in water.
  • Don't bite your fingernails or pick your cuticles.
  • Use disposable items in public places like salon, nail spa etc.
  • Eat a healthy and balanced diet.Maintain your hydration.

HOMEOPATHIC MANAGEMENT

There are medicines which can remove the periungual warts completely without recurrence. But medicine depends on the presentation of the case and should never be taken without consulting a registered homeopath. Homeopathy has permanent cure for periungual warts.

DO’s AND DON’Ts

Do’s

  • Wash the hands regularly.
  • Maintain hygiene.
  • Wear protective gloves when washing the dishes.
  • If someone has warts, avoid touching the area or items that have come into contact with them.
  • Use disposable items in public places like salon, nail spa etc.
  • Eat a healthy and balanced diet. Maintain your hydration.keep your personal items like nail clipper, towels, clothes separately, don't share them.

Don’ts

  • Do not share towels, nails polish, or other items
  • Don't bite your nails
  • Don't pick the nail cuticles. Don't cut the warts.