Superficial viral infections

Question 1

What are warts caused by

Answer 1

human papilloma viruses (HPV)

Question 2

What is the clinical experience of warts

Answer 2

• often asymptomatic

- can cause symptoms

Question 3

What symptoms can warts cause

Answer 3

• plantar warts become painful during ambulation
• condyloma acuminata (genital warts) can cause discomfort
• periungual lesions (tumor on the nail fold or bed) can develop painful fissures

Question 4

what does verruca mean

Answer 4

wart

Question 5

what are common warts (verruca vulgaris)

Answer 5

papules or nodules with a rough or scaly surface and typically occurs on the hands or fingers

Question 6

what are filliform warts

Answer 6

• slender, soft, thin growths

- seen most commonly on the face and neck

Question 7

what is periungal

Answer 7

• cluster-like (cauliflower)

- grows around fingernails and toenails

Question 8

what are plantar/palmar warts

Answer 8

firm, elevated, or flat lesions that are hyperkeratotic in nature

Question 9

what are condylomata acuminata (anogential warts)

Answer 9

soft, friable vegetating clusters found most commonly on the genitals
- asymptomatic in majority of patients

Question 10

What are the two treatment options for condylomata acuminata

Answer 10

podofilox

Imiquimod

Question 11

T/F HPV vaccination may reduce the incidence of genital warts

Answer 11

true

Question 12

what dosage form is podofilox (Condylox)

Answer 12

gel or solution

Question 13

what is podofilox indicated for

Answer 13

topical treatment external anogenital warts

Question 14

how should podofilox be dosed and administered

Answer 14

• apply twice daily to warts morning and evening q12h
• up to 4 weekly cycles of 3 consecutive days
• only apply minimum amount necessary, wash hands and do not reuse applicator

Question 15

what are some side effects associated with podofilox

Answer 15

burning (solution > gel)
pain (solution > gel)
inflammation (solution > gel)
itching (solution > gel)
erosion (solution < gel)
bleeding (gel)

Question 16

what are the two dosage forms of Imiquimod

Answer 16

3.75% cream (Zyclara) and 5% cream (Aldara)

Question 17

what is imiquimod indicated for

Answer 17

• external genital and perianal warts

- actinic keratosis and basal cell carcinoma

Question 18

what is the pharmacology of imiquimod

Answer 18

• immune response modifier

- no direct antiviral activity but induces cytokine activity

Question 19

which dosage form of imiquimod needs treatment longer

Answer 19

5% aldara : applied 3x/week at bedtime up to 16 weeks

Question 20

what warnings should we be aware when taking imiquimod

Answer 20

increased likelihood of sunburn

Question 21

what are some ADR of imiquimod

Answer 21

erythema, erosion, burning, excoriation/flaking, edema

Question 22

what clinical pearl should we be aware of while taking imiquimod

Answer 22

about as effective as podofilox with fewer side effects