438 Warts, Corn & Calluses

Warts Etiology

•Caused by HPVs
•Person to person contact
•Regress spontaneously 2-3 years if untreated

Warts signs & symptoms

•Begin: small, smooth, normal colored


•Become: slightly scaly


•Alone or in groups

Corns Etiology

•Caused by pressure from underlying bone pressure points or joints

Corns signs & symptoms

•Diameter 1cm or less, raised lesion with a central core

Calluses Etiology

•Caused by repeated friction and pressure

Calluses signs & symptoms

•Broad base with even thickening of skin
•Usually bottom or sides of foot
•Indefinite borders
•Usually raised and yellow

Warts Exclusions for self care

•

Warts goals of therapy

•Eliminate signs & symptoms of warts
•Remove the lesion withour scarring
•Prevent wart recurrence
•Prevent HPV spread to self/others

Warts non-pharma treatment options

•Treat early & aggressively
•Expect 4-12 weeks for treatment effect
•Wash hands before and after treating
•Dedicated towels
•No probing or trimming tissue
•Cover lesion

Warts treatment options

•Duct tape occlusion therapy
•Salicylic acid
•Cryotherapy

Warts follow up

•HCP after 4-6 weeks
•HCP after 12 weeks if not cleared

Duct Tape MOA & Indication

Irritates tissue causing stimulation of host immune response

Warts at any location

Duct tape pharmacodynamics

Efficacy in up to 2 months

Duct tape side effects

Adhesive rash
Waterlogged skin

When to avoid duct tape

If sensitivity to duct tape

Duct tape preg & lac

Safe

Duct tape dosing

•Cur silver duct tape to lesion size and apply
•Leave on lesion for 6 days
•Remove tape, soak in water & debride with pumice stone
•No tape that night; reapply next AM
•Continue until wart removed or max 2 months

Salicylic Acid MOA & Indication

Decreases keratinocyte adhesion, hydrates keratin;slowly destroys virus-infected cells

Common & plantar warts

Salicylic Acid Pharmacodynamics

Onset: 2 weeks
Dur: 12 weeks

Salicylic Acid Side Effects

Irritation of healthy skin
Salicylate toxicity if large amount absorbed through skin

Salicylic Acid Drug Interactions

Other agent that irritates skin

When to avoid Salicylic Acid

•Irritated, infected or reddened skin
•wart with hair growing from them
•genital, facial or mucous membrane warts
•Diabetes or circulatory disorder

Salicylic Acid Preg & Lac

Avoid

Cryotherapy agents

Nitrous oxide
Dimethyl ether+propane

Cryotherapy MOA

Irritation & destruction of tissue which stimulates host immune response against the virus

Cryotherapy Side Effects

•Burning, stinging
•Blistering
•burns, scarring
•Skin pigmentation changes
•Tendon or nerve damage

Cryotherapy Preg&Lac

Avoid

Corns& calluses Exclusions for Self-treatment

•Diabetes
•Compromised peripheral blood flow
•Rheumatoid arthritis
•Lesions bleeding or oozing
•Extensive or painful lesions on feet
•Ineffective self care

Corns& Calluses goals of therapy

•Relieve symptoms
•Remove corns and calluses
•Prevent recurrence by correcting cause

Corns& Calluses non pharma treatments

•Avoid trimming tissue with sharp implements/edges
•Protect healthy skin around lesions with petroleum jelly
•Cover area with a pad if pain and pressure under lesions
•Wear well-fitting, appropriately shaped shoes

Corns& Calluses Treatment

•Salicylic acid 17% in collodion like vehicle
•Salicylic acid 40% plasters/pads