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Biomechanics & Surgery Exam 3 > Verruca > Flashcards

Verruca Flashcards

1
Q

What are verruca warts caused by?

A

HPV

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2
Q

what kind of virus is HPV?

A

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

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3
Q

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

A

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

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4
Q

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

A

pH of 5 (seen in swimming pools)

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5
Q

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

A

4-20 months

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6
Q

verruca warts invade which layer of the skin?

A

purely epidermal in its histopathology

does not extend into the dermis

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7
Q

what are the 3 pathognomonic characteristics of verruca warts?

A
  • acanthosis
  • hyperkeratosis
  • papillomatosis
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8
Q

what is acanthosis?

A

thickening of stratum spinosum

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9
Q

what is hyperkeratosis?

A

thickening of stratum corneum

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10
Q

what is papillomatosis?

A

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

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11
Q

in which layer does DNA and protein production occur?

A

stratum spinosum

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12
Q

in which layer does final virus assembly occur?

A

granular layer

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13
Q

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

A

papillomatosis

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14
Q

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

A 
HPV 1 (common wart)
HPV 2 (mosaic wart)
HPV 4 (common wart)
HPV 10 
HPV 63- has also been implicated
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15
Q

how can you differentiate between a wart and IPK?

A

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

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16
Q

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

A

IPK- found on WB areas

warts & porokeratosis - found anywhere on plantar surface

17
Q

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

A

squamous cell CA

18
Q

What is the MOA for topical salicylic acid?

A

keratolytic agent- hastens de-squamation of the skin

19
Q

What is the MOA of Cantharidin?

A

is applied under occlusion and causes a severe blister

20
Q

What is the MOA of liquid nitrogen (cryosurgery)?

A

cell death occurs below -20C

21
Q

What is the MOA of liquid nitrogen (cryosurgery)?

A

cell death occurs below -20C

22
Q

what is the MOA of topical steroids?

A

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

23
Q

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

A

increases differentiation and proliferation of epidermis

24
Q

what is the MOA of 5-FU?

A

inhibits DNA synthesis

25
Q

what is systemic etretinate (Soriatane) MOA?

A

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

26
Q

what is MOA of Tagamet (cimetidine) ?

A

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

27
Q

what is MOA of 0.1% bleomycin ?

A

(intralesional injection therapy) - inhibits DNA synthesis

28
Q

what is the theory behind immunotherapy for treating verruca?

A

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

29
Q

what is MOA of 3% topical SADBE?

A

induces a delayed hypersensitivity reaction

30
Q

what is the MOA of Imiquimod (Aldara) cream?

A

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

31
Q

what is the needling technique?

A

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

32
Q

what is curettage technique?

A

-margin of wart bluntly dissected with tissue nipper

33
Q

what is hyfrecation?

A

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

34
Q

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

A

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

35
Q

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

A

red pigment –> causes thrombosis of vessels

Biomechanics & Surgery Exam 3 (11 decks)

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