The natural history of warts was recorded by examining 1,000 institutionalized mentally defective children for 2 years. Treatment of warts was withheld. We found: (1) The overall incidence increased from 18% to 25% in 2 years. (2) The dynamic aspect of warts was reflected by the fact that two-thirds of the original lesions in 168 cases involuted within 2 years. (3) Involution occurred almost twice as often in boys as girls. (4) Age and mental development of the patient and the incidence of warts in the immediate environment did not influence the rate of disappearance. (5) New warts occurred 3 times as frequently in infected children as in uninfected ones.
The role of the reservoir of warts in the community and in the individual is stressed as important prerequisites to infection. Therapy based on these findings should always be conservative and not mutilating. It should be directed at reducing the reservoir in the infected person and his immediate environment.