Warts

[ender18d]

Greetings from the sandbox.

OK gang... I've got a 20-30 Y/O WDWN Male indig personnel who works for us who's got a major problem with HPV. He's got 20+ lesions of various sizes covering both hands, and a handful more on his feet. Furthermore, I noticed he has some flat erythmatous plaques on his arms which he said were unrelated... But at the time I wasn't exactly boned up on EDV at the time, so it may be relevant. He's had a problem with warts since he was 8 years old. I usually like to use silver nitrate sticks to treat simple warts: apply, shave, apply. But I don't think I have enough sticks... not to mention that it would probably take a prohibitively large number of treatments to get rid of that way. I don't have any topical salacylic acid, but could get it. I don't have cryo, but I could *probably* arrange it. What's the best course of treatment for an HPV infestation this long-term and severe?

Is this clinical manifestation severe enough, considering the duration, to consider Epidermodysplasia Verruciformis? The age of onset is almost textbook. The distribution is about right as well.... If this is in fact EDV, then I know there is little that I can do other than teach him the S/S of carcinoma for early detection...

BTW I apologise for the blurry pics... I shot a little too close on some. But you should get the idea.