Warts Flashcards

1
Q

What are the clinical feature of verruca vulgaris?

A

hyperkeratotic, exophytic, dome-shaped papule or nodule

koebnerize

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2
Q

What is the most common location of verruca vulgaris?

A

fingers, dorsal hands, knees, elbows

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3
Q

What do the black dotes mean in verruca vulgaris?

A

thrombosed capillaries

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4
Q

What is koebnerize?

A

look up

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5
Q

What causes verruca vulgaris?

A

HPV 2, 4

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6
Q

What is the pathology of HPV wartz?

A

hyperplasia of epithelium

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7
Q

What does HPV infect?

A

basal keratinocytes of cutaneous and mucosal epithelium

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8
Q

How is HPV transmitted?

A

skin to skin or contaminated objects, wart to unaffected skin

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9
Q

What causes verrucae plana - flat warts?

A

HPV 3, 10

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10
Q

What causes palmoplantar warts?

A

HPV 1

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11
Q

What causes condylomata acuminata - external genital warts?

A

HPV 6, 11, 16, 18, 31

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12
Q

When is peak prevalence of warts?

A

13-16 yo adolescence, can also be younger and older

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13
Q

What percentage of warts resolve in 2 years?

A

75% but not realistic

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14
Q

How do you treat warts?

A

multiple tx, laser, acids, cryotherapy

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15
Q

What is the only FDA approved treatment for genital warts?

A

imiquimod

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16
Q

What are primarily irritating or destructive txs for warts?

A

cryotherapy, salicyclic acid, tretinoin cream, shave removal, adhesive tape, laser

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17
Q

What is the primarily immune stimulating tx for warts?

A

imiquimod, candida antigen (IL), immunotherapy (squaric acid or DCNB)

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18
Q

When do you use the candida antigen?

A

when other things fail

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19
Q

What are the side effects of cryotherapy?

A

PIPA (postinflammatory pigment alteration), scar, pain, blister, nail dystrophy

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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

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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?

24
Q

What are risk factors for EGW?

A

sex at early age, numerous partners, unprotected exposure

25
What is used for prevention of EGW?
HPV vaccine
26
What type of HPV infection does immunosuppressed pt get?
frequent, persistent, difficult to treat | higher risk of anal squamous cell carcinoma
27
Which of the following tx would you use for genetial warts?
cryotherapy, immiquimod, pdophyllin
28
What are the surgical tx for EGW?
laster, electrocautery, scissor, shave
29
How does verrucae planae present?
skin colored or pink, smooth surfaced slightly elevated
30
Where does verrucae planae occur?
dorsal hands, arms, face (exposed surfaces)
31
How does palmoplantar verruca present?
thick, endophytic (depressed into skin of soles) papules, mosaic warts --> large plaques --> thick callus over and around wart,
32
Are plantar warts painful?
yes when walking
33
What treatments do you start with?
ones that minimize side effects and risk of scarring
34
If you have few warts on your hand or foot, how do you treat?
salicyclic acid, adhesive tape, cryotherapy, laser
35
If you have few warts on face, how do you treat?
cryotherapy, shave (surgical) removal
36
If you have few warts at other sites, how do you treat?
cryotherapy and salicyclic acid
37
If you have many hand and foot warts, how do you treat>
salicyclic acid, cryotherapy, squaric acid or DCNB laser
38
If you have many face warts, how do you treat?
cryotherapy, tretinoin cream
39
If you have many warts at other sites, how do you treat?
imiquimod, tretinoin cream, squaric acid or DCNB
40
What is the mechanism of salicyclic acid?
keratolytic loosens connections btw keratinocytes, infected with HPV
41
What improves cure rate?
combo salicyclic acid and cryotherapy
42
What are the adverse effects of salicyclic acid?
erythema, peeling, irritation, maceration (due to occlusion)
43
Approximately what proportion of pt are wart free at 2 years w/o treatment?
60%
44
How do you do cryo?
two freeze cycles for 30 seconds or more, remove any thick overlying callus is removed
45
Smooth, dome shaped papules with central umbilication in genital area
molluscum contagiosum
46
papillomatous, exophytic papules and plaques in genital area
external genital warts
47
What are the surgical treatment for EGW?
laser, electrocautery, scissor or shave debulking
48
Who is gardasil FDA approved for?
M and F 9-29 yo
49
What vaccine is quadrivalent?
gardasil
50
What vaccine is bivalent against 16 and 18?
ceravix
51
Who is ceravix approved for?
females 10-25 (NO MALES)