Conclusions
autoinoculation, infection, cutaneous lesions, wart
WARTS, WART, INFECTION
Given the high prevalence of HPV types in cutaneous lesions, and their relationship with the clinical manifestation of warts, HPV genotyping with viral load determination can be of added value in daily clinical practice. Combined with the knowledge that the persistence of a lesion is linked to both the HPV genotype, wart type and number of warts, risk assessment can be performed, and therapeutical options can be suggested. In case that the above-defined risk factors are present in a subject, a more aggressive treatment approach can be applied in order to inhibit not only the spread of the infection in the general population but also further autoinoculation. Previous studies are in line with these findings. However, further research is needed to compose a comprehensive tool to guide clinicians in wart treatment and/or follow-up. For a more extensive assessment of HPV-dependent wart persistence, upcoming studies must entail large clinical trials comprising not only different treatment groups (e.g. salicylic acid, cryotherapy and wait-and-see) but also ensuring a sufficient HPV type-specific allocation in each group. Only then, a head-to-head comparison of different genotypes is possible, creating the possibility to make distinct claims about treatment response and natural course based on HPV type. Nevertheless, the present study already provides certain insights in possible predictors of wart persistence and encourages a more patient-centered and directed approach to wart risk and treatment stratification.