The prevalence of warts among children ranges from 22% to 33%. Treatment failure is common, but benign neglect is frequently appropriate as spontaneous resolution often occurs. Studies of the natural history of childhood warts are scarce and old.

Investigators examined the hands and feet of 1134 students (age range, 4–12 years) in three schools in the Netherlands for warts. A total of 366 children had warts at baseline. Plantar warts were identified in 70% and common warts in 42%; 43% had multiple warts, and 37% had a wart measuring >1 cm diameter. Of the 333 children available for follow-up at a mean of 15 months, 38% had had wart treatment (over-the-counter agents, physician treatment, or both). Complete resolution was defined as the absence of palpable and visible warts (skin color and skin lines were reestablished). At follow-up, the complete resolution rate was 52 per 100 person-years (95% confidence interval, 44–60). When newly developed warts were excluded, the resolution rate was 90 per 100 person-years (95% CI, 79–100). Rates were similar for common and plantar warts. The likelihood of resolution was higher in younger children and those with non-Caucasian skin type. The authors conclude that half of primary school children with warts will have resolution within 1 year.

by Mary Wu Chang, MD in Journal Watch, reviewing Bruggink SC et al. Ann Fam Med 2013 Sep/Oct.