Pediatric Dermatology Case: Treating Verruca Vulgaris on the Thumb of a Young Patient in Katy, TX
By: Dr. Ashley Baldree
Case Overview
At Village Dermatology, we routinely care for patients of all ages—especially children experiencing common dermatological concerns. One recent case involved a 4-year-old boy from the Katy and Houston, Texas area, who presented with a skin lesion on his left thumb. The lesion had been enlarging over several months, prompting concern from the family. This case highlights the importance of early intervention and education around pediatric viral skin conditions like verruca vulgaris (common warts).
Clinical Presentation
The young patient, otherwise healthy, had a moderate-sized wart on the distal radial side of the left thumb. His family reported the lesion had been present for months and was continuing to grow. There was no prior treatment history, and the child was brought in specifically for evaluation and potential management.
During the full physical exam, the dermatology team noted that the lesion had the classic cauliflower-like appearance typical of verruca vulgaris. A dermatoscope was used to confirm the diagnosis.
Diagnosis: Verruca Vulgaris
Verruca vulgaris, or the common wart, is a viral skin infection caused by the human papillomavirus (HPV). In children, warts are very common and often appear on the hands, fingers, and feet. They are contagious, can spread to other areas of the body or to others, and while benign, can cause discomfort, embarrassment, or functional limitation if left untreated.
Treatment Plan
To address the thumb lesion, the following steps were taken:
Cryotherapy with Liquid Nitrogen: The wart was treated with 2 freeze-thaw cycles of liquid nitrogen, a standard and effective therapy for many pediatric patients. Consent was obtained from the family prior to the procedure.
Salicylic Acid Topical Therapy: As part of ongoing home care, the patient was also prescribed topical salicylic acid, a proven adjunct therapy that helps soften and dissolve the wart over time.
Parental Counseling: The dermatology team counseled the family on proper wart care, including:
Avoiding direct contact with the lesion to prevent spread
Applying topical treatments consistently
Monitoring for recurrence or changes in appearance
Follow-Up Recommendations
The patient and family were instructed to monitor the area for healing or new lesions, and to follow up if:
The wart spreads to new locations
It fails to improve after several weeks of treatment
There is any change in color, size, or discomfort
Why Early Pediatric Wart Treatment Matters
While many warts in children can resolve on their own, professional evaluation ensures that no concerning features are missed, such as rapid growth, bleeding, or signs of other skin conditions. Early treatment also helps prevent spreading to other children—especially in shared environments like schools and playgrounds.
At Village Dermatology in Katy and Houston, TX, we specialize in compassionate, evidence-based pediatric dermatologic care that keeps families informed and involved.
