Demographics and epidemiology
Warts are a very common illness worldwide. In the United States, children are the most likely targets of the common wart viruses. Warts follow acne and atopic dermatitis in frequency of diagnosis in pediatric dermatology clinics [12, 13]. It is thought that 10-20% of children will at sometime be infected with warts [1, 3, 14]. The peak incidence of disease varies from study to study with some studies showing a peak age grouping of 8-9 years and others pointing to a peak age range between 12 and 18 year olds [1, 14-16]. The incidence of plantar warts has doubled from its incidence in 1968, which was then found in 1.8-2.9% of primary and secondary school children, to currently 4.5% . Females and males are equally affected by HPV infections. The leading sites of HPV infection are the extremities, face and body. Hand warts are often transferred to other cutaneous sites including the lips, nose, and face, via autoinoculation. Autoinoculation is generally the route of disease extension or spreading; however, some patients may be exposed to the HPV in multiple sites at the same time.
As noted previously, HPV infection is more easily acquired through wet or moist skin. Studies have shown that users of communal showers at a gymnasium are 27 times more likely to catch warts, obviating the need for pool shoes or sandals when using communal pools and showers .
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