Warts and Verrucas & Corns and Calluses

Question 1

What causes warts and verrucas?

Answer 1

human papilloma virus (HPV)

Question 2

What are symptoms of warts and verrucas?

Answer 2

Raised lesions with a roughened surface 
Plantar warts (verrucas) occur on the weight-bearing areas of the sole and heel. 

Warts have a network of capillaries and these may be visible as black dots

Question 3

When do symptoms disappear?

Answer 3

naturally within 6 months to 2 years

Question 4

Where are warts normally found?

Answer 4

hands, fingers, knees either single or in crops

Question 5

Where are verrucas found?

Answer 5

soles of the feet, weight bearing areas

Question 6

When to refer?

Answer 6

1. Facial warts
2. Change in appearance (size&colour) of a wart - may suggest skin cancer
3. Bleeding
4. Itching
5. Genital warts
6. Immunocompromised pts
7. No significant improvement within 3 months of OTC tx
8. Diabetics

Question 7

What are tx options for warts and verrucas?

Answer 7

1. Salicylic acid softens and destroys skin, therefore aiding the removal of infected tissue
   - Lactic acid is an antimicrobial keratolytic that enhances availability of salicylic acid
2. Cryotherapy OTC products have little evidence supporting their use but can be tried and the wart should come away in about 10 days
3. Duct tape is comparable to OTC cryotherapy in effectiveness
4. Glutaraldehyde

Question 8

What counselling points can be given so that treatment works more effectively?

Answer 8

Soak the affected hand or foot in warm water for 5-10 minutes
Remove dead skin with the use of a pumice stone or emery board
Avoid transferring infection by exposing others to the skin of the infected site

Question 9

What salicylic acid preps have age restrictions and what are they?

Answer 9

Compound W = >6 years

Bazuka Extra Strength = >2 years

Question 10

What salicylic acid and lactic acid preps have age restrictions and what are they?

Answer 10

Bazuka >2 years

Duofilm >2 years

Question 11

Name other salicylic acid preps.

Answer 11

Occlusal
Verrugon
Wartex

Question 12

Name other salicylic acid and lactic acid preps

Answer 12

• Cuplex
• Salactol
• Salatac

Question 13

What is the OTC name for glutaldehyde?

Answer 13

Glutarol

Question 14

What are the main side effects of the wart and verruca preparation?

Answer 14

Local irritation

Question 15

How can you differentiate from a corn or verruca?

Answer 15

remove the top layer of the skin - if black spots are visible this is a verruca, if not, thi indicates a corn

Question 16

What is the length of the tx?

Answer 16

usually 3mnths -slow process

Question 17

Whats the difference between bazuka and bazuka extra?

Answer 17

extra has a high content of salicylic acid but doesn’t mean its more efficacious

Question 18

Which pts should you NOT recommended treatment?

Answer 18

diabetics

Question 19

How do corns and calluses form?

Answer 19

friction and intermittent pressure against one of the boney prominences of the feet - causing hyperkeratoses (excessive skin growth of the shoe and the foot)

Question 20

What are clinical features of corns?

Answer 20

Central core of hard grey skin surrounded by a painful, raised, yellow ring of inflammatory skin

Question 21

What are clinical features of calluses?

Answer 21

flattened, yellow-white thickened skin

burning sensation, resulting from fissuring of the callus

Question 22

What tx options is offered for the removal of corns and calluses?

Answer 22

metatarsal pads relieves weight off the callus and so reduce stress on the plantar skin

or same meds for warts and verrucas