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Biomechanics & Surgery Exam 3 > Verruca > Flashcards

Flashcards in Verruca Deck (35):
1

What are verruca warts caused by?

HPV

2

what kind of virus is HPV?

ds DNA virus surrounded by an icosohedral (has 20 sides) capsule

3

HPV warts are very persistent, what is this attributed to?

lack of Langerhans cells at site of lesion, leading to decreased T-cell response

4

what type of environment does HPV thrive in to promote infection/

pH of 5 (seen in swimming pools)

5

do warts have an incubation period? if so, for how long?

4-20 months

6

verruca warts invade which layer of the skin?

purely epidermal in its histopathology
(does not extend into the dermis)

7

what are the 3 pathognomonic characteristics of verruca warts?

-acanthosis
-hyperkeratosis
-papillomatosis

8

what is acanthosis?

thickening of stratum spinosum

9

what is hyperkeratosis?

thickening of stratum corneum

10

what is papillomatosis?

upward proliferation of epidermal papillae causing surface of epidermis to show irregular undulation

11

in which layer does DNA and protein production occur?

stratum spinosum

12

in which layer does final virus assembly occur?

granular layer

13

what are the black dots or petechiae that are seen clinically within the white fibrotic base of the wart due to?

papillomatosis

14

what are the 3 most common forms of HPV causing plantar warts in humans?

HPV 1 (common wart)
HPV 2 (mosaic wart)
HPV 4 (common wart)
HPV 10
HPV 63- has also been implicated

15

how can you differentiate between a wart and IPK?

wart will hurt with side-to-side compression whereas an IPK will hurt more on direct compression

16

where are IPK's found? how about in comparison to warts? or porokeratosis?

IPK- found on WB areas
warts & porokeratosis - found anywhere on plantar surface

17

for some verruca, you worry about it undergoing transformation to what?

squamous cell CA

18

What is the MOA for topical salicylic acid?

keratolytic agent- hastens de-squamation of the skin

19

What is the MOA of Cantharidin?

is applied under occlusion and causes a severe blister

20

What is the MOA of liquid nitrogen (cryosurgery)?

cell death occurs below -20C

21

What is the MOA of liquid nitrogen (cryosurgery)?

cell death occurs below -20C

22

what is the MOA of topical steroids?

under occlusion, it inhibits cell division and synthesis of DNA in epidermis

23

what is the MOA of tretinoin (topical Vitamin A)?

increases differentiation and proliferation of epidermis

24

what is the MOA of 5-FU?

inhibits DNA synthesis

25

what is systemic etretinate (Soriatane) MOA?

systemic retinoid for psoriasis but can be taken orally to clear warts

26

what is MOA of Tagamet (cimetidine) ?

interferes with suppressor T-cell function, so inflammatory response against virus is prolonged

27

what is MOA of 0.1% bleomycin ?

(intralesional injection therapy) - inhibits DNA synthesis

28

what is the theory behind immunotherapy for treating verruca?

theory is to induce a delayed cutaneous hypersensitivity reaction against the wart

29

what is MOA of 3% topical SADBE?

induces a delayed hypersensitivity reaction

30

what is the MOA of Imiquimod (Aldara) cream?

-recruits cytokines and IFN-alpha to induce keratinocytes to produce enzymes to block viral replication

31

what is the needling technique?

needle is inserted repeatedly into the wart, and works by destruction of tissue and induction of inflammatory response

32

what is curettage technique?

-margin of wart bluntly dissected with tissue nipper

33

what is hyfrecation?

electrodessication that uses spark-gap technology and causes tissue dehydration --> cell death ensues with thrombosis of blood vessels

34

light passed thru a CO2 gas chamber is absorbed by what?

water --> so any tissue that absorbs this will become fried

35

light passed thru a chamber of dye is absorbed by what?

red pigment --> causes thrombosis of vessels