No end to warts

[Quince]

First I had a plantar wart that was cured by the usual topical salicylic acid medication.  Later another wart on my palm where the medication failed and had to be cauterized.

Now I have three warts  on my fingers, one tiny and one (on the tip) that's half a centimeter across and two years old.  They are all below the surface, similar to plantar warts.  Medication and multiple freezings have failed, due to the depth the warts are.  I'm worried that surgery will also fail, and for the large wart at the tip, I'm worried about tissue damage from surgery as the root is very deep.

On top of this, on the back of my thumb, at the first knuckle, recently the skin has turned very dry, somewhat reddened and swollen, and peels a bit, like some sort of eczema.  Nearby there's yet another wart, that may be related to the eczema, or perhaps a secondary infection.

And finally, I have a millimeter sized wart on the foreskin of my penis (hidden until I pull back the foreskin) surrounded by a few tiny warts (turns white in vinegar test); this has been around for a few years.  It is unlikely for me to have contracted an STD, so I think this is an infection from my hand warts.

I don't know if these three are related.  If they are all the same virus, then wouldn't I need to treat all simultaneously to avoid reinfection?  And what treatment is left when the freezing has failed?  I've heard of treatment with interferon; would that be the only approach, and how do I find a doctor that can offer such a thing in Canada?

[Alan Rockoff, MD]

First of all. having warts in several locations is not that odd, and does not necessarily imply anything basically wrong with you.  Second, you can't transmit warts from one part of the body to another (if you could, we would all be covered with warts.)  Third, warts don't have "roots"--they live entirely within the epidermis, though in some places like the palms and soles the epidermis is thicker.  Fourth, surgery is not a good idea--recurrence is common, and scarring may be permanent.  Fifth, I am not at all sure that your penile lesions are warts--your description does not sound like them, and vinegar tests have many false positives.

My advice is to see a sensible dermatologist who can examine all your warts, and recommend gentle but effective treatment.  I usually advise cryosurgery and lots of patience.

Best.

Dr. Rockoff