ABSTRACT
The diagnosis is usually obvious from the appearance and association with warts elsewhere. Paring the surface may give the characteristic pinpoint bleeding seen in all vital warts.
Warts beneath the nail should be exposed for assessment. They may reflect an underlying bony exostosis which can be revealed by X-ray (plane and lateral). Longstanding atypical warts in adults occasionally turn out to be squamous cell carcinoma and therefore warrant biopsy.
