OSCE — Viral Warts (Verrucae)

Brief (to candidate)

You will assess a patient with a presentation consistent with Viral Warts (Verrucae).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Viral warts (verrucae) are benign epidermal proliferations caused by human papillomavirus (HPV) infection of basal keratinocytes. Clinical subtypes: common (verruca vulgaris) — rough, hyperkeratotic papules on hands, fingers and knees (HPV 1, 2, 4, 27); plantar (verruca plantaris/myrmecia) — tender, inward-growing on soles with pathognomonic black dots that are thrombosed capillary loops (HPV 1); flat (verruca plana) — smooth, flat-topped papules on face and hands (HPV 3, 10, 28); filiform — finger-like projections on face and neck; genital (condyloma acuminata) — sexually transmitted cauliflower-like lesions (HPV 6, 11; oncogenic 16, 18, 31, 33). Most cutaneous warts resolve spontaneously i

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[2]