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| Fig. 26.2 A, Multiple reddish-brown macules of the back in a patient with epidermodysplasia verruciformis. B, 'Kissing' warts produced by inoculation of the toe web space. (Courtesy of James E. Fitzpatrick, MD.) |
Yes, especially if they are injured. Such injury may happen if the warts are in a location traumatized by shaving or scratching. This reaction is known as the Koebner phenomenon. (The Koebner reaction is also present in skin conditions that have no known viral cause, such as psoriasis and lichen planus.) Close approximation of two surfaces, where one surface is affected and the opposing surface is unaffected, is also associated with an increased likelihood of spreading (e.g., adjacent toe surfaces; Fig. 26-2B).
