Pediatric warts: update on interventions.

Warts are superficial viral infections of the skin that are extremely common in children. The infection usually lasts more than 1 year and can be moderately contagious in specific settings; for instance, warts are particularly common and spread more easily in the setting of atopic dermatitis, a chronic, itchy pediatric skin condition caused by barrier and immune defects. Therapies for pediatric warts are characterized according to 6 major categories: destructive; immune stimulating; immune modulating, including normalization of epithelial growth; vascular destructive; irritant; and nitric oxide releasing. The standard of care is the use of destructive therapies, with immune-stimulating and vascular destructive therapies reserved for more prolonged, extensive, or treatment-resistant infections. In this article, a successful paradigm for management of pediatric warts is provided, with enhanced outcomes based on further insight into the disease course and patient selection.