Y5 - Cutaneous warts

Question 1

def

Answer 1

elevated round hyperkeratotic skin papules with a rough greyish-white or light brown surface

Question 2

where do warts commonly occur

Answer 2

at sites prone to trauma (knees and elbows)

Question 3

what do filiform warts look like

Answer 3

a stalk like appearance with multiple spikes

Question 4

aetiology

Answer 4

HPV infection of keratinocytes

Question 5

what forms of HPV commonly cause warts

Answer 5

1, 2, 4, 27, 57, 63

Question 6

what are butcher warts

Answer 6

repetitive trauma to the hands

Question 7

what form of HPV classically causes butcher warts

Answer 7

7

Question 8

RFs

Answer 8

water immersion (swimming or regular dishwashing)
immunosuppression

Question 9

pathophysiology

Answer 9

infection of keratinocytes by HPV caysing koilocytosis (viral transformation of the keratinocyte) and proliferation

Question 10

epi

Answer 10

children and young adults

Question 11

signs and symptoms

Answer 11

lesion growth over months
round raised papule
tiny black dots on surface of lesion

Question 12

what do the tiny black dots on a wart represen

Answer 12

thrombosed capillaries

Question 13

RFs

Answer 13

water immersion
handling meat/fish
immunocompromised

Question 14

investigations

Answer 14

clinical diagnosis

Question 15

management of immunocompetent patient

Answer 15

any of:

• debridement and salicylic acid
• cryotherapy
• silver nitrate solution

Question 16

management of a immunocompromised patient

Answer 16

any of:

• debridement and salicylic acid and immunotherapy
• cryotherapy and immunotherapy

Question 17

management for a filiform wart

Answer 17

cryotherapy

Question 18

complications

Answer 18

treatment related scarring

Question 19

prognosis

Answer 19

commonly will resolve spontaneously in immunocompetent individuals