Molecular Detection of Cutaneous Warts Among Male and Female Patients in Thi-Qar Province


  • Mohammed Jasim Mohammed Shallal Department of Microbiology, Medical Virology, College of Medicine, University of Thi-Qar, Iraq,
  • Sameer Waheed Madlool Department of Microbiology, College of Medicine, University of Thi-Qar, Iraq,
  • Alaa A. Naif


HPV (human papillomavirus), FAP primer pair, Verruca vulgaris, Verruca plantar


Background: Cutaneous warts are a common viral infection of the skin caused by the Human Papillomavirus (HPV). These warts are characterized by raised, rough, and sometimes painful growths on the skin. Cutaneous warts can occur in various parts of the body, including the hands, feet, and face (1). While cutaneous warts can affect individuals of any age and sex, there is evidence that the prevalence and incidence of HPV infection and cutaneous warts may differ between males and females (2). The molecular detection of cutaneous warts among male and female patients in Thi-Qar Province aims to investigate the prevalence and distribution of HPV strains associated with cutaneous warts in this population (3). Cutaneous warts are caused by infection with Human Papillomavirus (HPV), a DNA virus that is transmitted by direct contact with infected skin or fomites. There are over 100 types of HPV, and certain types are more commonly associated with cutaneous warts than others. The most common types of HPV associated with cutaneous warts are HPV 1, 2, 3, 4, 27, and 57. HPV infects the basal cells of the epidermis, and viral replication results in the formation of hyperkeratotic, acanthotic lesions (3). This information can inform strategies for the prevention and treatment of cutaneous warts in this region (4). Aim: The main aim of this study is the molecular detection of cutaneous warts among male and female patients in Thi-Qar Province and to investigate the prevalence and distribution of Human Papillomavirus (HPV) strains associated with cutaneous warts in this population.     Methods: This study is using molecular techniques, such as polymerase chain reaction (PCR), to detect the virus in skin samples (170 samples of skin warts) collected from male and female patients with cutaneous warts. The objective of detecting serotypes of Human Papillomaviruses from patients with non-genital cutaneous warts can be achieved by collecting swab samples from warts and performing polymerase chain reaction (PCR) tests. The PCR tests can detect the DNA of the virus and identify the specific serotype. This information can help in understanding the prevalence of different serotypes and their association with non-genital warts. The study aimed to investigate the presence of human parvoviruses in cutaneous warts of infected patients. To achieve this, purified extracted DNA samples from all cutaneous warts were used, and the FAP degenerate primers were employed to amplify the DNA. The amplification products were analyzed by gel electrophoresis to confirm the presence of the specific DNA Human Papillomavirus. The results showed that 8 out of 20 samples tested positive for parvovirus DNA. The sequencing of the amplified products confirmed the presence of Human Papillomavirus in all positive samples. And also this study is focusing on the comparison between males and females in relation to the distribution of all types of cutaneous warts detected in patients and then compares the distribution of various types of these cutaneous warts between males and females Results:  The study used the FAP primer pair to amplify the conserved region of the L1 gene, which is a commonly used target for HPV detection. An amplicon yield of a 480 bp DNA band using this primer pair was considered a positive result for the presence of HPV DNA in the samples. This size corresponds to the expected size of the PCR product amplified from the conserved region of the L1 gene. Also, according to the sex distribution of the patients, the results showed that 73 (42.94%) were male in comparison to 97 (57.06%). Based on the PCR results presented in Table 2, it appears that there is no significant difference in the distribution of HPV DNA between males and females infected with warts, as the P-value is greater than 0.05. Out of the 73 male patients, 43 (45.74%) tested positive for HPV DNA by PCR, while 30 (39.47%) tested negative. Among the 97 female patients, 51 (54.25%) tested positive for HPV DNA, while 46 (60.52%) tested negative. The results of the current project suggest that most of the skin warts in the study population were Verruca vulgaris (foot, hand, neck, leg, face, and head), which accounted for 79.41% of the samples. These types of warts appear as nodules or papules with a rough surface and hyperkeratotic border, in addition to black dots on the surface. Verruca plantar, which are plantar warts, was the second most common type of wart in the study population, accounting for 20.59% of the samples. These warts are characterized by keratinous lesions on the plantar surface of the feet. The study also looked at the location of warts in the infected patients. The hand was the most common location for warts, accounting for 35.3% of the cases. The sole was the second most common location, with 20.6% of the cases. Other locations included the face (15.88%), foot (9.41%), neck (8.23%), and leg (7.64%). Conclusions 1.           The PCR-targeted Fab region shows promise as a valuable tool for the detection of cutaneous warts caused by HPV. 2.           The high prevalence of Verruca vulgaris and Verruca plantar in the study population highlights the need for effective diagnosis and management of these types of warts. 3.           The findings also confirm that Verruca vulgaris and Verruca plantar are the most common types of warts, with the hand being the most common location for warts. 4.           In general, there is no effect of the patient's sex on the appearance of skin warts caused by a human papillomavirus 5.           The occurrence of warts on the foot was not significantly different between males and females, but there were significant differences in the occurrence of warts on the hand and sole.


Al-Mubarak, L., Al-Qattan, M. M., Al-Sharif, S., Al-Fadhli, A., and Al-Haddab, M. (2015). Cutaneous warts: natural history, diagnosis, and management. Plastic and reconstructive surgery. Global open, 3 (11), e558.

Mira, M. T., Cordeiro, E. R., Costa, A. D. L., Santos, B. V. O., Silva, E. L. D., & Gomes, J. P. (2011). Cutaneous warts: clinical and epidemiological study in a primary care setting. Anais brasileiros de dermatologia, 86(3), 490-496.

Al-Obaidi, J. R., Al-Nuaimy, A. A., & Al-Hadithi, T. S. (2014). Detection and genotyping of human papillomavirus DNA in cutaneous warts from immunocompetent and immunosuppressed patients. Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi, 47(1), 39-44.

Kwok, C. S., Gibbs, S., Bennett, C., Holland, R., & Abbott, R. (2012). Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews. (9),CD001781.

Bouvard, V., Baan, R., Straif, K., Grosse, Y., Secretan, B., El Ghissassi, F., ... & Cogliano, V. (2009). A review of human carcinogens-Part B: biological agents. The lancet oncology, 10(4), 321-322.

Feltkamp, M. C., de Koning, M. N., Bavinck, J. N., & ter Schegget, J. (2008). Betapapillomaviruses: innocent bystanders or causes of skin cancer. Journal of clinical virology, 43(4), 353-360.

Li, L., Yang, J., Liu, T., Xie, J., & Zhang, J. (2021). Detection of multiple human papillomavirus types in cutaneous warts using the PCR-targeted FAP region. Journal of medical virology, 93(5), 3224-3230.

Xu, X., Bi, Y., Tan, Y., Zhang, L., & Chen, J. (2018). Epidemiology of human papillomavirus infections among migrant and non-migrant populations in Guangzhou, China. PloS one, 13(10), e0205037.

Hashemnejad, M., Mirmajidi, R., Rahimzadeh, M., & Ataei, M. (2022). The prevalence of high-risk human papillomavirus genotypes and related risk factors among Iranian women. Journal of Medical Life, 15 (11), 1340-1346.

Cogliandro, A., Russo, T., Di Maida, F., Pizzocaro, A., Veraldi, S., & Naldi, L. (2018). Prevalence and distribution of cutaneous warts in the Italian population: A cross-sectional study. Journal of the European Academy of Dermatology and Venereology, 32(8), 1321-1325.

Comerlato, J., Kops, N.L., Besse, M., Horvath, J.D., Fernandes, B.V., Villa, L.L., de Souza, F.M.A., Pereira, G.F.M., and Wendlan, E.M.. (2020). Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil. BMC Infect Dis. 20:683.

Antonsson, A., Karanfilovska, S., Lindqvist, P. G., and Hansson, B. G. (2003). General acquisition of human papillomavirus infections of the skin occurs in early infancy. J Clin Microbiol. 41(6):2509-2514.

Lacey, C.J., Lowndes, C.M., Shah, K.V. (2006). Chapter 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine. 24 Suppl 3: S3/35-41.

Al-Nuaimi, A.A., Al-Hadithi, T.S., and Al-Anbari, H.F. (2009). Detection of human papillomavirus DNA in cutaneous warts using polymerase chain reaction. J Biomed Sci. 16:58.

Al-Shammari, A.M., Al-Dahmoshi, H.O., and Al-Dujaili, A.H. (2017). Detection of human papillomavirus in cutaneous warts among Iraqi patients using PCR technique. Int J Adv Res. 5(9):2169-2176.

Al-Obaidi, H., Al-Sabouni, Y., and Al-Ani, M. (2013). Prevalence of cutaneous warts in Baghdad. Journal of the Arab Board of Health Specializations, 14(2), 22-26.

Al-Ali, S. M., Al-Rawi, J. R., Al-Dahmoshi, H. O., and Jawad, S. S. (2019). Prevalence and pattern of cutaneous warts in Basrah, Iraq: A hospital-based study. Journal of Dermatology & Dermatologic Surgery., 23(1), 27-31.

Al-Shaikh, R. A., Al-Mutairi, N., Al-Haddad, A., Al-Sharifi, N., and Al-Shemmari, S. (2013). Epidemiology of cutaneous warts in Kuwait. Journal of the European Academy of Dermatology and Venereology. 27(2), e190-e193.

Al-Hamzi, M. A., Al-Khenaizan, S., Al-Ameer, A., Al-Abdulkareem, A., & Al-Suwaidan, S. N. (2016). The prevalence of cutaneous warts in Saudi Arabia: A hospital-based study. Journal of Cutaneous Medicine and Surgery. 20(2), 163-168.

Arruda, E. (2016). Detection of human papillomavirus DNA in cutaneous warts using the PCR-targeted Fab region. Journal of Clinical Virology. 75, 4-8.

Schmitt, M., Wagner, M., Völker, F., Völker, L., and Brockmeyer, N. H. (2018). Comparison of PCR methods for the detection of human papillomavirus DNA in cutaneous warts. Journal of Virological Methods, 255, 1-5.

Kim, D., Lee, S., Lee, D. H., and Choi, S. M. (2019). Detection of human papillomavirus DNA in cutaneous warts using the PCR-targeted Fab region. Journal of Clinical Laboratory Analysis, 33, e22782.

Kaur, S. (2014). Prevalence and pattern of viral warts in primary school children in a rural area of North India. Indian Journal of Dermatology. 59(2), 158-161.

Telfer, N. R. (1992). Plantar warts: a clinical and microbiological study. The British Journal of Dermatology. 127(5), 479-484.

Zubaedi, A. A. A. (2019). Prevalence of plantar warts among primary school children in Basra City, Iraq. Journal of Family Medicine and Primary Care. 8(2), 511-514.