Warts, Corns and Calluses Flashcards
How are warts caused
HPV infection
*caused by person-to-person contact
autoinoculation to another body part
transmission on fomites
What are the 3 criteria for wart development
presence of HPV
opening in the skin
susceptible immune system
What are some risk factors for warts
history of warts
immunocompromised
chronic skin condition
walking barefoot
use of public bathing/swimming areas
nail biting
working at meat-handling facility
What is the clinical presentation of common warts
skin-colored or brown lesions
rough, cauliflower texture
usually painless
What is the clinical presentation of plantar warts
skin-colored lesions appearing on the feet
extend deeper into the skin
may be painful
*named after bottom surface of foot
What are the exclusions for self-treatment
under the age of 3 if using salicylic acid products
under the age of 4 years if using cryotherapy products
unable to follow instructions
pregnant or breastfeeding
immunocompromised status
chronic conditions like diabetes, PVD, and/or neuropathy
large and/or multiple warts concentrated in a particular area
bleeding, painful, or discolored warts
warts found on sensitive areas of the body
little to no improvement after 12 weeks of self-treatment
What is the main focus when treating warts
Preventing the spread of HPV
What are non-pharmacologic options we can take to prevent the spread of HPV
avoid shaving, cutting or picking at warts
avoid walking around barefoot
wash hands before and after contact with warts
use a designated towel on affected areas
avoid sharing towels, razors, socks and shoes
keep feet clean and dry
cover warts
How long may a person self-treat warts for?
MAX of 12 weeks
What is the MOA of salicylic acid
keratolytic agent
“exfoliant” for warts
How long does it usually take for salicylic acid to start working
1-2 weeks
Who should not use salicylic acid treatment for warts
those younger than 3 years old
salicylate allergy
patients on immunosuppressive agents
patients that are pregnant or lactating
What is the dosing for salicylic acid for warts?
apply 1-2 times a day if using the liquid/gel
apply every 48 hours if using the pad/plaster
Can you combine salicylic acid with any other treatment options
yes, can combine with cryotherapy and duct tape
What is the MOA of cryotherapy
destroys warts by freezing them off with nitrous oxide or a mix of dimethyl ether and propane
What is the dosing and usage guideline for cryotherapy
wash hands before and after use
before treatment, soak affected area in warm water for 5 minutes
wash and dry area thoroughly
Prepare and activate device according to the device instructions
apply to wart until a halo appears around the wart
*approx 20 secs for common wart and 40 secs for plantar wart
repeat after 2 weeks if needed
*max of 3 treatments or for up to 12 weeks
What are some cautions with cryotherapy
treat only one side of finger/toe at a time
treat ONE wart at a time
apply directly to wart ONLY
protect eyes during use
do not ingect or inhale chemicals
keep away from children
avoid areas with thin skin
avoid irritated or infected skin
do NOT use for moles of birthmarks
AVOID in pregnancy or lactation(unless medically advised)
do NOT use in those under the age of 4
What is used for occlusion therapy
silver duct tape
What is the process of using duct tape for occlusion therapy
cut duct take to size of lesion or slightly large
apply and leave on wart for 6 days
remove on evening of sixth day
soak in warm water and debride with pumice stone
replace the next morning with a new piece of duct tape
ONLY USE SILVER DUCT TAPE
What causes corns and calluses
increase of friction and pressure leads to increased growth of the basal cell skin layer
What is the clinical presentation of corns
small, raised lesion with a central core and defined border appearing on bony joints
hard corns: found on tops of toes near joints
soft corns: found between toes
What is the clinical presentation of calluses
thickening of skin with an indefinite border
found at the bottom/sides of the foot
usually somewhat raised and dull yellow in color
When should you not self-treat corns and calluses
less than 3 years of age
chronic conditions
history of rheumatoid arthritis with prominent metatarsal bone heads or great toe deviation
fault in body weight distribution
bleeding or oozing purulent material
painful or extensive in nature
self-care ineffective
What are some complementary and non-pharmacologic options for corns and calluses
soak affected area in warm water for at least 5 minutes daily and then remove dead tissue with a callus file of pumice stone
use circular foam cushioning pads or polymer gel pad to protect and relieve pressure
wear appropriately fitted shoes
wear arch supports
avoid trimming tissue
*surgical correction may be needed if severe
What is the pharmacological treat for corns
Soft corns: salicylic acid in collodion vehicle 1-2 times a day for 3-6 days
Hard corns/calluses: salicylic acid 1-2 times a day OR plaster pad every 48 hours for 14 days
