Viral Warts Flashcards
What are warts?
Typically small, rough and hard growths similar in colour to the rest of the skin
How can warts be classified?
Based on shape and site affected
Give some types of wart?
- Common wart
- Flat wart
- Genital wart
- Plantar wart
What is a common wart?
A raised wart with a roughened surface, common on the hands but can appear anywhere
What is a flat wart?
A small, smooth, flattened, flesh coloured wart.
Where do flat warts commonly grow?
- Face
- Neck
- Hands
- Wrists
- Knees
What is a plantar wart also known as?
Verruca
What is a verruca?
A hard, sometimes painful lump often with multiple black specks in the centre
Where are verrucas usually found?
Pressure points on the soles of the feet
What are the characteristic features of a common wart under a microscope?
- Thickened stratum corneum (hyperkeratosis)
- Thickened stratum spinosum (acanthosis)
- Thickened stratum granulosum
- Large blood vessels at the dermoepidermal junction
What type of virus causes warts?
HPV
What are the most common causes of common warts?
HPV 2 and 4
What is the most common cause of verrucas?
HPV 1
What are anogenital warts most commonly caused by?
HPV 6 and 11
How is HPV acquired?
Direct contact with affected individual or from the environment e.g. contaminated surfaces
What is likely to contribute to development of warts?
Trauma and wetness
What can cause a wart to spread from one area to another?
Trauma and scratching
What does not cause warts?
Toads?🐸
What are the risk factors for warts?
- Use of public showers
- Working with meat
- Eczema
- Immunocompromised
Do warts usually cause symptoms?
Only pain in verrucas
How can warts appear on dermatoscope?
With fingerlike or knoblike extensions
What are the differentials for viral warts?
- Actinic keratosis
- Cutaneous horn
- Lichen planus
- Molluscum contagiosum
- Seborrhoeic keratosis
- Malignancy
- Corns and calluses
What are the management options for viral warts?
- Nothing
- Topical salicylic acid
- Cryotherapy
- Other treatments in secondary care
Why do warts not always need treatment?
- They self-resolve
- Treatment is time-consuming and may have side-effects
What is the first-line therapy for viral warts
Topical salicylic acid
What is the treatment regimen for viral warts with salicylic acid?
Daily treatment for at least 12 weeks
How often is cryotherapy needed to remove warts?
Every 2 weeks until wart has gone (up to 4 months)
What are the problems with cryotherapy for viral warts?
- Can be painful
- Can cause blistering
- Should be avoided in children
How else may viral warts be treated in secondary care?
- Removal by surgery, laser or photodynamic therapy
- Anti-mitotic agents
- Virucidal agents
- Immunomodulatory agents
Why may a referral to secondary care be needed in viral warts?
- Uncertain diagnosis
- Persistant symptomatic warts
- Multiple warts in immunocompromised individuals
- Facial warts
- Extensive coverage
What is not recommended as a treatment for warts?
Touching a toad under a full moon????🐸🌝
