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Q: can warts develop from cat scratches? ( Answered 5 out of 5 stars,   0 Comments )
Question  
Subject: can warts develop from cat scratches?
Category: Health > Conditions and Diseases
Asked by: banchan-ga
List Price: $9.92
Posted: 06 Dec 2002 20:56 PST
Expires: 05 Jan 2003 20:56 PST
Question ID: 120696
good evening dear researchers~

i did a preliminary search on google for the answer to this question,
but i didnt see anything in the first several pages of results, so im
asking for perhaps some personal experience or concrete knowledge
about this.

october 11, i was scratched on my fingers by my cat (i was trying to
give him a bath because he was very very dirty).  there were two
superficial scratches on my ring and middle finger of my right hand,
on the palm side.

the scratches have healed, but there are six points in the line
ofwhere the scratches were that have developed into bumps.  four of
them are rather large (to me -- the smallest of the four is about 4 mm
diameter and the largest is about 8 mm) and all (even the smaller two
bumps) are tender and painful to touch.  the area where the scratch
actually used to be on all six points is very small, white and i guess
i would describe it as kind of dry (i am tempted to say crusty, but
there is no excretion of anything).  the area around the points are
inflammed as if they were infected.

i went to my primary care physician and she looked at it back in early
november and shrugged and said, 'eh, they'll shrink and go away, i
wouldnt worry about it.  some scratches take some time to heal'  she
didnt seem to think that they were infected (which was the big worry)
so i didnt worry.  except that one of them is really painful.  and
they sure are taking their time healing.  i suppose it doesnt help
that i do the dishes, clean and prep & cook food a lot with my bare
hands.  i guess ill buy some gloves to do the dishes...  :)

they feel like warts.  they look puffy and seem to have some kind of
tough, callousey mass underneath which is not puss nor water and they
hurt like warts (which i had long ago in high school at the base of my
big left toe).  im going to go and ask to see a dermatologist in
january (if the bumps are still there) but i was really curious if
anybody had ever heard of this.

am i crazy?  i am not looking for a diagnosis, but i would like to
know if it is possible to develop warts from scratches.  guesses other
than warts are also most welcome and no matter what the answer/guesses
are, i wont hold any of you to it!  :-)  like i said, i did a quick
search on google ("cat scratch wart" was the best i could come up
with.  weak, huh?)  and that didnt seem to lead anywhere and i thought
it would just be quicker to ask here.  :-)

thank you very much for your kind attention.
Answer  
Subject: Re: can warts develop from cat scratches?
Answered By: kevinmd-ga on 07 Dec 2002 12:54 PST
Rated:5 out of 5 stars
 
Hello,
Thanks for asking this interesting question.

I have not seen your lesion and it is impossible to give you an
accurate diagnosis.  I will discuss the various possibilities of
infection secondary to a cat scratch.

To directly answer your question:

Can warts develop from scratches?

From UptoDate:
"Human papillomaviruses (HPV) infect epithelial tissues of skin and
mucous membranes. The most common clinical manifestation of these
viruses is warts (verrucae) . . .  Infection with HPV occurs by
skin-to-skin contact, with maceration or sites of trauma (i.e. a cut)
predisposing patients to inoculation." (1)

So the short answer is yes, it is possible.

I will next discuss Cat-Scratch Disease which may be relevant to the
information you provided.

Cat scratch disease (CSD) is an infectious disease characterized by
self-limited regional lymphadenopathy. Current serologic and culture
data provide convincing evidence that Bartonella (formerly
Rochalimaea) henselae is the etiologic agent in most cases of CSD. 
The manifestations of CSD, however, can include ocular, neurologic,
and visceral organ involvement.

CSD typically begins with a cutaneous lesion at the site of
inoculation, the so-called primary inoculation lesion. This lesion
usually develops three to ten days after the introduction of the
organism into the skin and generally evolves through vesicular,
erythematous, and papular phases. Less commonly the primary
inoculation lesion can be pustular or nodular. One report described a
patient who developed a paronychia (painful periungal inflammation)
caused by B. henselae as a manifestation of an inoculation site
lesion. The primary inoculation lesion typically persists for about
one to three weeks (range several days to several months).

Other uncommon cutaneous manifestations of CSD include a transient
macular and papular eruption, erythema multiforme, erythema nodosum,
and thrombocytopenic purpura.

"Warts" may be mistaken for a cutaneous manifestation of CSD. I would
strongly recommend following up with your primary care physician or
dermatologist.

I will be happy to discuss factual questions about the diagnosis and
treatment of Cat-Scratch Disease in a seperate question.

Please use the answer clarification to ask any questions before rating
this answer.  I will be happy to explain any issue.
 
Thanks, 
Kevin, M.D. 
 
Search strategy: 
No internet search engine was used in this answer.  All sources are
from objective, physician-written, peer-reviewed resources.
 
Bibliography:
1) Goldstein et al. Cutaneous warts.  UptoDate, 2002.
2) Spach et al. Cat scratch disease.  UptoDate, 2002.
banchan-ga rated this answer:5 out of 5 stars
good answer, even though i dont understand a lot of the terminology.

thank you.

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