PT III Warts, Corns and Calluses (Kieck) (Exam 3)

HPV

what are warts caused by?

common warts

typically found on: hands

common among children

color: skin-colored or brown

shape: dome-shaped or cauliflower-like

yes

are common warts self-treatable?

plantar warts

typically found on: feet

common among young adults

color: skin-colored

shape: callus-like, flat, disrupt normal foot markings

yes

are plantar warts self-treatable?

mosaic warts

typically found on: feet

common among young adults

color: skin-colored

shape: callus-like, flat, disrupt normal foot markings

several plantar warts

no

are mosaic warts self-treatable?

flat warts

typically found on: face

common among children

color: yellow or brown

shape: smooth and flat

no

are flat warts self-treatable?

filiform warts

typically found on: face

common among children

shape: thread-like projections

rapidly growing

no

are filiform warts self-treatable?

location of warts besides hands or feet

large or multiple warts located on one area of the body (mosaic)

bleeding, painful, or discolored warts

warts that occur on inflamed, infected or irritated skin

poor circulation or decreased skin sensitivity (diabetes)

immunocompromised

pregnant or breastfeeding

children less then 3 y/o (SA) or 4 y/o (cryo)

warts that have not been resolves after 12 weeks of treatment

what are self-care exclusions for warts? (9)

remove wart without scaring

prevent recurrence

prevent spread of HPV

what are goals of treatment for warts? (3)

avoid further autoinoculation (no cutting, shaving, or picking)

avoid transmission to others

managing discomfort (use padding)

what are non-pharm recommendations for warts? (3)

salicylic acid or cyrotherapy

what are the two pharm treatment options?

salicylic acid

keratolytic agent (break down the outer layer or skin, destroying virus infected cells)

40%

what formulation of salicylic acid is used typically for plantar warts?

17% liquid and gel

what formulation of salicylic acid is used typically for common warts?

up to 12 weeks

how long should a wart be treated with salicylic acid?

do not give if a child or teenager is recovering from chicken pox or flu

do not apply to broken skin

what are precautions for salicylic acid? (2)

anticoagulants or corticosteroids (increased risk of bleeding)

what are drug interactions for salicylic acid?

stick to area of the wart, not on healthy tissue

bandage or cover

remove plaster, pad or strip after 48 hours

repeat every 48 hours until wart is resolved

what are counseling points for salicylic acid 40%?

use as directed on the label for up to three treatments

what are directions for cryotherapy?

vitamin A

zinc

garlic (allium sativum)

occlusion with duct tape

what are complementary therapy for warts? (4)

corns

caused by pressure of underlying bony prominences or joints

hyperkeratotic lesion with hard central core

calluses

broad base with even thickening of skin

heel and ball of foot

indefinite boarders and rages in diameter

forms over joints and weight baring areas

caused by friction

diabetes and peripheral circulatory disease

lesions hemorrhaging or oozing purulent material

anatomic defect or fault in weight distribution

extensive pain

unsuccessful self-care treatment

history of rheumatoid arthritis and painful metatarsals or deviation of big toe

what are self-care exclusions for corns and calluses? (6)

provide symptomatic relief

remove corns and calluses

prevent their recurrence by correcting underlying causes

what are goals of treatment for corns and calluses? (3)

daily soaking for at least 5 min in warm water

remove dead tissue gently with a pumice stone

do not use sharp knives or razor blades

use cushioning pads to relieve pressure

eliminate pressure causing corns/calluses

what are non-pharm recommendations for corns and calluses? (5)

salicylic acid

up to 14 days

what are treatment options for corns and calluses? up to how long?

shaving the top layer of a wart will result in pinpoint bleeding vs corns/calluses do not bleed

corns are painful, calluses and warts are not

how do you distinguish between warts and corns/calluses?

apply 1 drop at a time to cover the wart. protect nearby healthy skin from coming into contact with the medication

let the solution dry

cover wart with self-adhesive disk or occlusive tape

repeat 1-2 times per day until wart resolves (up to 12 weeks)

what are counseling points for salicylic acid liquid or gel?