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Subungual Wart under Fingernail

  • Some people may refer to subungual warts as fingernail warts, but the name is somewhat of a misnomer. Subungual warts are actually growths that occur under the fingernail instead of on it. 
  • They are also far more common than their fingernail counterparts, typically occurring in between five and ten percent of the population. Subungual warts are caused by HPV, a virus that is also the cause of many other common types of warts such as the common hand wart.
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  • Subungual warts are small growths on the surface of the fingernails or toenails. The warts can range in size from a few millimeters to a centimeter in diameter.
  •  They are most commonly found on the fingernails, but they can also appear on the toenails. Subungual warts are caused by a virus, and they aren't cancerous.
  • Subungual warts are small, flesh-colored bumps that can appear on the skin near your fingernails. They’re often mistaken for other common skin conditions, like eczema or mild psoriasis, but subungual warts are actually caused by a virus. Subungual warts are generally harmless, but may cause discomfort, itchiness and bleeding if they spread. 
  • They can be easily removed with a simple scraping or shave, but it’s best to see a doctor if you think you have a subungual wart.
  • Subungual warts under fingernail are resistant to both chemical and surgical treatment. A wart under the nail could be totally submerged beneath the nail.Treatment The nail region is narrow.Treatments that cause inflammation and edema, such as cryotherapy, cause significant pain, sometimes unbearable by patients.

Cryosurgery

  • Conservative cryosurgery works on small periungual warts but not on warts that extend under the nail.Neuropathy has been caused by aggressive cryosurgery over superficial nerves on the volar or lateral aspects of the proximal phalanges of the fingers.
  • If the nail matrix is frozen, permanent nail changes may occur.

Cantharidin (cantharone)

  • It causes blistering at the dermal-epidermal junction.Post-inflammatory hyperpigmentation, painful blistering, and spreading warts in the blister area are all side effects.The solution is applied to the surface, allowed to dry, and then occluded with tape during treatment.A week later, the patient is assessed.The blisters are opened and the remaining wart is removed.
  • Cantharidin is applied in one to three layers and covered with tape for 48 hours if blistering does not occur.Each coat must be dry before applying the next coat of cantharidin.Although the treatment is very effective for some patients, some warts do not respond to repeated applications.The solution is applied to the surface, dried, and then occluded with tape.
  • After one week later, the patient is controlled.Blisters are opened, and warts are eliminated.Solution will be re-applied in 1-3 layers than covered for 48 hours if blistering does not occur.Each layer should be dry before applying the next one.This treatment is very effective for some patients, but some patients do not respond.

Keratolytic treatment 

  • The same methods used to treat plantar warts with salicylic acid and lactic acid paint and salicylic acid plasters can be used to treat periungual warts.

Blunt Dissection 

  • When classic treatments do not work, blunt dissection is an the best surgical procedure. 
  • When the wart is imbedded, the nail should be removed, there is no other surgical option. 

Duct tape occlusion

  • For common warts, duct tape occlusion therapy may be more effective than cryotherapy.Duct tape is wrapped around the tip of the finger to completely cover the wart.
  • The tape is left in place for 6 days, then removed at home, reapplied in a similar manner 12 hours later, and left in place for another 6 days.
  • This procedure is repeated every 2 months for up to 2 months.



  • Subungual warts are common types of warts that can appear under the nail at any age. They do not have the typical appearance of a classic wart.
  • This type of wart has distinct symptoms and treatments.
  • Warts are caused by a virus : the human papillomavirus infection (abreviation : HPV) .
  • There are More than 100 of types this virus.Different strains of the infection have different effects on you.HPV infection begins in the outer layers of your skin and spreads to the skin cells.It produces infectious virus cells that cause warts after penetrating a specific layer of skin cells.
  • HPV 1, 2, 3, and 4 are the most common causes of subungual warts.HPV is transmitted or acquired through skin contact or contamination.Picking or touching your wart may result in the formation of a new wart on a different part of your skin.Depending on the circumstances, HPV can take up to a year to fully incubate and form a wart.



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