OSCE Verrucae Flashcards
What are Verruacaes/warts
Verrucaes are skin infections also known as warts caused by the HPV virus. It causes hyperplasia of the stratum spinosum leading to a thickening of the tissue in this area and infection of keratinocytes by the HPV virus
It has double stranded DNA
How would you diagnose this condition what assesments would you perform
Verrucaes are genrally doagnosed by there clinical apperance but i would
Take patient history
* How long have you had it for
* How painful is it
* can you charecterise the pain for me
* Pinch push test to rule out any other pathologies such as seed corn or HDs
* Condcut a vascular assesment to establish the quality of their blood supply as a weak blood supply could affect wound healing and the majority of the treatments available include some form of tissue damage
What are the different types of Verrucae
Warts/Verucaes are typically diagnosed by there clinical appearance
- Plantar Warts - appear encapsulated and when pinched cause a sharp pain. That can aid with diffrential diagnosis as they sometimes get mistaken for seed corns or HDs so by pinching them we can determine whether their warts or not.
- Established verrecaues have a rough cauliflower like apperance
- regressing warts show a yellowish orange colour
- Caused by HPV 1
- Mosaic warts - cluster of warty tissue
- site can vary and can include the plantar aspect, interdigital and subungal
- Caused by HPV 2
Periungal/Subungal warts
* situated around the nail area painful and disturb nail growth
Filliform warts
* long thin apperance usuaslly found on the face
How would you manage this condition what treatment options would you provide
Primary = 2
Secondary = 3
what advice would you give
Nice guidelines state that in primary care options can include:
* Topical sayclic acid anywhere from 15-50% daily for 12 weeks
* Cryotherapy with liquid nitrogen every 2 weeks until gone with a max 6 treatments
In secondary care options include:
* Laser treatment
* Physical ablation
* surgery
I would then give them advice regarding wound preperation and dressing if secondary care was the chosen option:
* So having a warm saline footbath
* re dressing with a dry dressing and being aware of the signs of infection
I’d also give them advice on the risk of cross contamination:
* So wearing protective footwear in communal areas
* Avoid sharing socks shoes
* keep the feet dry and clean
And then to prevent personal spread
* Avoid scratching the area
* change socks daily
What is the aetiology/ predisposing risk factors 4
immunosupressed patients
HIV patients
Diabetic patients
People who are exposed to communal areas such as changing rooms, swimming pools any contaminated surfaces basically
