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Dermatology - Clinical Medicine IV > Warts > Flashcards

Flashcards in Warts Deck (51)
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1
Q
What are the clinical feature of verruca vulgaris?
A
hyperkeratotic, exophytic, dome-shaped papule or nodule
koebnerize
2
Q
What is the most common location of verruca vulgaris?
A
fingers, dorsal hands, knees, elbows
3
Q
What do the black dotes mean in verruca vulgaris?
A
thrombosed capillaries
4
Q
What is koebnerize?
A
look up
5
Q
What causes verruca vulgaris?
A
HPV 2, 4
6
Q
What is the pathology of HPV wartz?
A
hyperplasia of epithelium
7
Q
What does HPV infect?
A
basal keratinocytes of cutaneous and mucosal epithelium
8
Q
How is HPV transmitted?
A
skin to skin or contaminated objects, wart to unaffected skin
9
Q
What causes verrucae plana - flat warts?
A
HPV 3, 10
10
Q
What causes palmoplantar warts?
A
HPV 1
11
Q
What causes condylomata acuminata - external genital warts?
A
HPV 6, 11, 16, 18, 31
12
Q
When is peak prevalence of warts?
A
13-16 yo adolescence, can also be younger and older
13
Q
What percentage of warts resolve in 2 years?
A
75% but not realistic
14
Q
How do you treat warts?
A
multiple tx, laser, acids, cryotherapy
15
Q
What is the only FDA approved treatment for genital warts?
A
imiquimod
16
Q
What are primarily irritating or destructive txs for warts?
A
cryotherapy, salicyclic acid, tretinoin cream, shave removal, adhesive tape, laser
17
Q
What is the primarily immune stimulating tx for warts?
A
imiquimod, candida antigen (IL), immunotherapy (squaric acid or DCNB)
18
Q
When do you use the candida antigen?
A
when other things fail
19
Q
What are the side effects of cryotherapy?
A
PIPA (postinflammatory pigment alteration), scar, pain, blister, nail dystrophy
20
Q
What are the clinical features of external genital warts?
A
not hard or hyperkeratotic, sessile papules, may be papules or large confluent plaque
21
Q
Where are genital warts present?
A
external genitalia, perineum, perianal, inguinal fold
22
Q
How do you do cryotherapy?
A
white ring 2-3 mm outside bump 2x
23
Q
Who has the highest incidence of EGW?
A
20-34 yo
24
Q
What are risk factors for EGW?
A
sex at early age, numerous partners, unprotected exposure
25
Q
What is used for prevention of EGW?
A
HPV vaccine
26
Q
What type of HPV infection does immunosuppressed pt get?
A
frequent, persistent, difficult to treat
higher risk of anal squamous cell carcinoma
27
Q
Which of the following tx would you use for genetial warts?
A
cryotherapy, immiquimod, pdophyllin
28
Q
What are the surgical tx for EGW?
A
laster, electrocautery, scissor, shave
29
Q
How does verrucae planae present?
A
skin colored or pink, smooth surfaced slightly elevated
30
Q
Where does verrucae planae occur?
A
dorsal hands, arms, face (exposed surfaces)
31
Q
How does palmoplantar verruca present?
A
thick, endophytic (depressed into skin of soles) papules, mosaic warts --> large plaques --> thick callus over and around wart,
32
Q
Are plantar warts painful?
A
yes when walking
33
Q
What treatments do you start with?
A
ones that minimize side effects and risk of scarring
34
Q
If you have few warts on your hand or foot, how do you treat?
A
salicyclic acid, adhesive tape, cryotherapy, laser
35
Q
If you have few warts on face, how do you treat?
A
cryotherapy, shave (surgical) removal
36
Q
If you have few warts at other sites, how do you treat?
A
cryotherapy and salicyclic acid
37
Q
If you have many hand and foot warts, how do you treat>
A
salicyclic acid, cryotherapy, squaric acid or DCNB laser
38
Q
If you have many face warts, how do you treat?
A
cryotherapy, tretinoin cream
39
Q
If you have many warts at other sites, how do you treat?
A
imiquimod, tretinoin cream, squaric acid or DCNB
40
Q
What is the mechanism of salicyclic acid?
A
keratolytic loosens connections btw keratinocytes, infected with HPV
41
Q
What improves cure rate?
A
combo salicyclic acid and cryotherapy
42
Q
What are the adverse effects of salicyclic acid?
A
erythema, peeling, irritation, maceration (due to occlusion)
43
Q
Approximately what proportion of pt are wart free at 2 years w/o treatment?
A
60%
44
Q
How do you do cryo?
A
two freeze cycles for 30 seconds or more, remove any thick overlying callus is removed
45
Q
Smooth, dome shaped papules with central umbilication in genital area
A
molluscum contagiosum
46
Q
papillomatous, exophytic papules and plaques in genital area
A
external genital warts
47
Q
What are the surgical treatment for EGW?
A
laser, electrocautery, scissor or shave debulking
48
Q
Who is gardasil FDA approved for?
A
M and F 9-29 yo
49
Q
What vaccine is quadrivalent?
A
gardasil
50
Q
What vaccine is bivalent against 16 and 18?
A
ceravix
51
Q
Who is ceravix approved for?
A
females 10-25 (NO MALES)