Hi,
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After going through the history and images provided by your end (attachment removed for patient identity protection), they appear as DPN (dermatosis papulosa nigerians). They do not appear as warts from the images. DPN is basically skin tags that appear on the skin in multiple locations, including the face, neck, nape of neck and sides, underarms and chest, trunk, and private areas. They are harmless and most often asymptomatic. For some individuals, however, they may cause mild irritation, itching, pain in case of infection, and so on. They appear due to reasons most often genetic. Wherein there may be family history that may be passed on genetically. They form small to big-sized tags or peduncles on the skin, which may be skin-colored, light or dark brown, black, and sometimes red as well. They are not contagious. However, they may increase in size. They also occur on areas of friction due to running between skin surfaces as well. Although harmless, they may be bothersome.
Warts, on the other hand, although does not appear to be on the images, are basically viral infections caused by HPV (human papillomavirus), which may be contagious and spread within one's body usually after being spread from another individual and may appear on and off in case of lowered immunity.
Warts may be removed with the persistent use of medications. However, DPN (dermatosis papulosa nigerians) requires procedures but not surgical intervention. However, they may recur on and off months or years later in the same spots or new areas, which may require to be managed similarly as advised below each time they appear.
My advice :
1. Watnil solution should be used in case of the presence of warts. A layer of Vaseline is to be applied around the wart areas to prevent the solution from seeping into the unaffected areas. A drop of the solution may be applied to the wart lesion only. They are to be used at night, and plaster with cotton placed in the center of the plaster, which may come in contact with the wart lesion, may be placed overnight. The plaster may be removed in the morning, and the area may be washed. Make sure to continue the same for four weeks to till the lesions reduce. The cotton is placed in the center to prevent pain while removing the plaster in the morning. This medication is strong and will be used only on warts, not DPNs.
2. Tablet Ascazin (zink acetate) 50 mg to be taken for warts orally in the morning and at night after food for one month. They help with preventing the spread of warts and strengthen immunity.
3. DPN (dermatosis papulosa nigerians), on the other hand, may only be removed with a single-day procedure called radiofrequency cauterization, where the lesion is burnt using a probe after numbing the area using a cream. They are painless and OP procedures that take only a few minutes to remove each DPN (dermatosis papulosa nigerians). Following this, an antibiotic cream may be advised for faster healing of the area. This procedure is done at a dermatologist's clinic and may require in-person consultation for undergoing the procedure.
4. As you have already mentioned, lasers are also available, which work in a similar manner for removing the DPN (dermatosis papulosa nigerians) in a single session. However, radiofrequency cauterization is inexpensive and better for removal.
5. Make sure to keep skin moisturized to avoid friction and the formation of DPNs in the future.
6. Cryotherapy is also a procedure where instead of burning the lesion, they are frozen, eventually falling off within a few days. They may be slightly painful but again is a single-day procedure done at an OP (outpatient).
As I have mentioned, unfortunately, DPNs (dermatosis papulosa nigerians) and moles, if present, may only be removed by these procedures. However, they are not surgeries and do not require anesthesia, and are done in a single session within a few minutes. They are inexpensive as well. However, they do have a tendency to recur and may be managed each time they recur in a similar manner. Laser is not mandatory. radiofrequencies methods may be helpful for DPN removal.
Thank you.