Warts and Verrucas

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Warts and Verrucas

Lymphedema People

http://www.lymphedemapeople.com

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Originally Posted by Silkie 05/08/2005

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Response

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Pat

Hi Ya Silkie

Warts (verucas) are fairly common and almost everyone may have experience them at one time or another.

Because a lymphedema limb is immunocompromised, it is at greater risk for them. Clusters on the feet would be a normal way for them to express themselves as of course, it is the feet that are in direct contact with the pavement at any pool. Pools are another subject and are high risk areas also for lymphedema because of possible impetigo, erysipelas and cellulitis infections - so I urge great caution there.

If you do go to a public pool, always be sure to wear sandals (flip flops) or something on your feet - never walk around the pavement or walkways around a pool without something on your feet.

They can be frozen off, or now days removed by use of laser. Never, ever cut them of or try to pull them off. Even without lymphedema, that can lead to some serious infections.

Here are a couple pages on warts I found that may be helpful.

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What are Plantar Warts?

Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus, which generally invades the skin through small or invisible cuts and abrasions. They can appear anywhere on the skin, but, technically, only those on the sole are properly called plantar warts.

Children, especially teenagers, tend to be more susceptible to warts than adults; some people seem to be immune.

Identification Problems

Most warts are harmless, even though they may be painful. They are often mistaken for corns or calluses—which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.

It is also possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart. It is wise to consult a podiatric physician when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis.

Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown (but the color may vary), with a center that appears as one or more pinpoints of black. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.

Source of the Virus

The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.

If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts; these are often called mosaic warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed, another route for spreading.

Occasionally, warts can spontaneously disappear after a short time, and, just as frequently, they can recur in the same location.

When plantar warts develop on the weight-bearing areas of the foot—the ball of the foot, or the heel, for example—they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.

Tips for Prevention

Avoid walking barefoot, except on sandy beaches.

Change shoes and socks daily.

Keep feet clean and dry.

Check children's feet periodically.

Avoid direct contact with warts—from other persons or from other parts of the body.
Do not ignore growths on, or changes in, your skin.

Visit your podiatric physician as part of your annual health checkup.

Self Treatment

Self treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue. Self treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use them in the presence of an active infection.

Professional Treatment

It is possible that your podiatric physician will prescribe and supervise your use of a wart-removal prepa- ration. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthetic, may be indicated.

Lasers have become a common and effective treatment. A procedure known as CO2 laser cautery is performed under local anesthesia either in your podiatrist’s office surgical setting or an outpatient surgery facility. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions.

Self treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue. Self treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use them in the presence of an active infection.

Tips for Individuals with Warts

Avoid self treatment with over-the-counter preparations.

Seek professional podiatric evaluation and assistance with the treament of your warts.

Diabetics and other patients with circulatory, immunological or neurological problems should be especially careful with the treament of their warts.

Warts may spread and are catching. Make sure you have your warts evaluated to protect yourself and those close to you.

http://www.apma.org/s_apma/doc.asp?CID=146&DID=9430

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Warts

What causes warts?

Warts are a type of infection caused by viruses in the human papillomavirus (HPV) family. There are at least 60 types of HPV viruses. Warts can grow on all parts of your body. They can grow on your skin, on the inside of your mouth, on your genitals and on your rectal area. Some types of HPV tend to cause warts on the skin, while other HPV types tend to cause warts on the genitals and rectal area. Some people are more naturally resistant to the HPV viruses and don't seem to get warts as easily as other people.

Can warts be passed from one person to another person?

Yes. Warts on the skin may be passed to another person when that person touches the warts. It is also possible to get warts from using towels or other objects that were used by a person who has warts.

Warts on the genitals can be passed to another person during sexual intercourse. It is important not to have unprotected not allowed if you or your partner has warts on the genital area. In women, warts can grow on the cervix (inside the vagina), and a woman may not know she has them. She may pass the infection to her sexual partner without even knowing it.

Will warts go away on their own?

Sometimes yes and sometimes no. Often warts disappear on their own, although it may take many months, or even years, for the warts to go away. Some warts won't go away on their own. It is not known why some warts disappear and others don't.

Do warts need to be treated?

Generally, yes. Warts are often bothersome. They can bleed and cause pain when they're bumped. They also can cause embarrassment, for example, if they grow on your face. Treatment may also decrease the chance that the warts will be spread to other areas of your body or to other people.

How are warts on the skin removed?

First of all, it's important to know that warts on the skin (such as on the fingers, feet and knees) and warts on the genitals are removed in different ways. Don't try any home remedies or over-the-counter drugs to remove warts on the genital area. You could damage your genital area by putting certain chemicals on it. You also shouldn't treat warts on your face without talking to your doctor first. The following are some ways to remove warts from the skin:

Applying salicylic acid--For warts on places such as the hands, feet or knees, one treatment method is to put salicylic acid (one brand name: Compound W) on the warts. To get good results, you must apply the acid every day for many weeks. After you take a bath or shower, pat your skin dry lightly with a towel. Then put salicylic acid on your warts. The acid sinks in deeper and works better when it is applied to damp skin. Before you take a shower or a bath the next day, use an emery board or pumice stone to file away the dead surface of the warts.

Applying cantharidin--Your doctor may use cantharidin on your warts. With this treatment, the doctor "paints" the chemical onto the wart. Most people don't feel any pain when the chemical is applied to the wart. You'll experience some pain and blistering of the wart in about 3 to 8 hours. After treatment with cantharidin, a bandage is put over the wart. The bandage can be removed after 24 hours. When mixtures of cantharidin and other chemicals are used, the bandage is removed after 2 hours. When you see your doctor again, he or she will remove the dead skin of the wart. If the wart isn't gone after one treatment, your doctor may give you another treatment.

Applying liquid nitrogen--Your doctor may use liquid nitrogen to freeze the wart. This treatment is called cryotherapy. Applying liquid nitrogen to the wart causes a little discomfort. To completely remove a wart, liquid nitrogen treatments may be needed every 1 to 3 weeks for a total of 2 to 4 times. If no improvement is noted, your doctor may recommend another type of treatment.

Other treatments for warts on the skin--Other ways that your doctor can remove warts on the skin include burning the wart, cutting out the wart and removing the wart with a laser. These treatments are stronger, but they may leave a scar. Ask your doctor about the risks and benefits of these treatments before you decide what kind of treatment to have for your warts.

Do warts ever come back?

Most of the time, treatment of warts is successful and the warts are gone for good. Your body's immune system can usually get rid of any tiny bits of wart that may be left after a wart has been treated. If warts come back, though, see your doctor to talk about other ways to treat them.

Family Doctor.org

http://familydoctor.org/209.xml

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Hope this help!!

Pat

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Bleomycin Treatment for Verrucae

Background: The treatment of verrucae with bleomycin injections has not become a routinely adopted form of therapy in dermatologic practice since its use was originally described in 1980 because of the adverse effects and complications that have been associated with it.

Objectives: The goal of this study was to demonstrate the results and the incidence of adverse effects from the use of bleomycin in clinical practice in a retrospective study of patients presenting with verrucae and to demonstrate the convenience and ease of the methodology that was used in obtaining these results.

Methods: Patients’ lesions were injected with bleomycin every 3 to 4 weeks until the lesions had been eliminated or the injections were discontinued because of adverse effects or complications.

Results: There were 211 patients in the study, and 224 lesions were treated. After 1 treatment, 47.6% of the lesions were cleared; another 38.8%were cleared after 2 treatments; and another 9.8% were cleared after 3 treatments. In total, 96% of lesions were cleared after 5 treatments. A small number of temporary adverse effects were noted: 3 patients had local chemical cellulitis, 2 patients had formation of sterile abscesses, 1 patient had postinflammatory hyperpigmentation, and 1 patient had localized pain. No local or systemic complications were observed. Conclusions. Therapy with intralesional bleomycin is a relatively rapid and convenient form of therapy, compared with other available treatments, from the point of view of both the patient and the physician. (SKINmed. 2007;6:166–171)

http://www.lejacq.com/Search_ArticleDet ... N=69294705

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Warts

Alternative names

Plane juvenile warts; Periungual warts; Subungual warts; Plantar warts; Verruca; Verrucae planae juveniles; Filiform warts; Verruca vulgaris
Definition Return to top

Warts are small, usually painless growths on the skin caused by a virus. They are generally harmless. However, warts can be disfiguring and embarrassing, and occasionally they itch or hurt (particularly on the feet).

The different types of warts include:

Common warts usually appear on the hands, but can appear anywhere.

Flat warts are generally found on the face and forehead. They are common in children, less so in teens, and rare in adults.

Genital warts are usually found on the genitals, in the pubic area, and the area between the thighs, but can appear inside the vagina and anal canal.
Plantar wartsare found on the soles of the feet.

Subungual and periungual warts appear under and around the fingernails or toenails

Causes, incidence, and risk factors

The typical wart is a raised round or oval growth on the skin with a rough surface. Compared with the surrounding normal skin, warts may appear light, dark, or black (rare). Most adults are familiar with the look of a typical wart and have little trouble recognizing them. Unusual warts with smooth surfaces or flat warts in children may be more difficult for parents to recognize.

Common warts tend to cause no discomfort unless they are in areas of repeated friction or pressure. Plantar warts, for example, can become extremely painful. Large numbers of plantar warts on the foot may cause difficulty running and even walking.

Warts around and under your nails are much more difficult to cure than warts elsewhere.

Some warts will disappear without treatment, although it can sometimes take a couple years. Treated or not, warts that go away often reappear. Genital warts are quite contagious, while common, flat, and plantar warts are much less likely to spread from person to person. All warts can spread from one part of your own body to another.

Because people generally consider warts unsightly and there is often a social stigma, treatment is often sought.

Symptoms

Small, hard, flat or raised skin lesion or lump

Abnormally dark or light skin surrounding the lesion

Numerous small, smooth, flat (pinhead sized) lesions on forehead, cheeks, arms, or legs

Rough, round, or oval lesions on soles of feet -- flat to slightly raised -- painful to pressure

Rough growths around or under fingernails or toenails

Signs and tests

Warts can generally be diagnosed simply by their location and appearance. Your doctor may want to cut into a wart (called a biopsy) to confirm that it is not a corn, callus, or other similar-appearing growth.

Treatment

Over-the-counter medications can remove warts. These are applied to the wart every day for several weeks. DO NOT use these medications on your face or genitals. It helps to file the wart down when damp (for example, after a bath or shower) before applying these medications.

Special cushions are available at drugstores for plantar warts. These pads help relieve any pressure and pain from the warts.

Stronger (prescription) medications may be required for removal of persistent warts. Surgical removal or removal by freezing (cryotherapy), burning (electrocautery), or laser treatment may be needed.

Immunotherapy, done by injecting a substance that causes an allergic reaction, may also be considered by your doctor.

A vaccine called Gardasil prevents infection against the strains of viruses that often cause genital warts and cervical cancer in women.

DO NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.

Expectations (prognosis)

Warts are generally harmless growths that often go away on their own within two years. They can be contagious, but transmission from person to person is uncommon. Warts may be unsightly or cause discomfort, especially on the feet.

Complications

Spread of warts
Return of warts that disappeared
Minor scar formation if the wart is removed
Formation of keloids after removal

Calling your health care provider

Call for an appointment with your doctor if:

There are signs of infection (red streaking, pus, discharge, or fever) or bleeding. Warts can bleed a little, but if bleeding is significant or not easily stopped by light pressure, see a doctor.

The wart does not respond to self-care and you want it removed.

You have pain associated with the wart.

You have anal or genital warts.

You have diabetes or a weakened immune system (for example, HIV) and have developed warts.

There is any change in the color or appearance of the wart.

Prevention

Avoid direct skin contact with a wart on someone else.

After filing your wart, wash the file carefully since you can spread the virus to other parts of your body.

After touching any of your warts, wash your hands carefully.

References

US Food and Drug Administration. FDA Licenses New Vaccine for Prevention of Cervical Cancer and Other Diseases in Females Caused by Human Papillomavirus. Rockville, MD: National Press Office; June 8, 2006. P06-77.

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004:368-378.

Kasper D, Braunwald E, Fauci A, et al. Harrison's Principals of Internal Medicine. 16th edition [online version]. New York, NY: McGraw Hill; 2005.

Update Date: 4/12/2007
Updated by: Kevin Berman, MD, PhD, Associate, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network.

http://www.nlm.nih.gov/medlineplus/ency ... 000885.htm

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Pulsed dye laser therapy for pediatric warts

Pediatr Dermatol. 2007 Mar-Apr

Park HS, Kim JW, Jang SJ, Choi JC.
Department of Dermatology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. gsjfirst@empal.com

Viral wart infections constitute one of the most common pediatric skin diseases, and various modalities have been used to manage them. Although pulsed dye laser therapy is known to be a safe and efficacious modality, the reported cure rates for this method have varied, and no studies have reported treatment of pediatric patients alone.

This prospective, nonblinded, nonrandomized study was performed to evaluate the efficacy and safety of pulsed dye laser therapy for pediatric warts. We found that this method is safe, relatively effective, and worth considering as an additional therapeutic option for viral warts in children, although not as a first-line therapy.

http://www.blackwell-synergy.com/doi/ab ... 07.00370.x

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Topical zinc oxide vs. salicylic acid-lactic acid combination in the treatment of warts.

Int J Dermatol. 2007 Apr

Khattar JA, Musharrafieh UM, Tamim H, Hamadeh GN.
Department of Family Medicine, Faculty of Health Sciences, American University of Beirut Medical Center, Beirut, Lebanon. jkhattar@cyberia.net.lb

BACKGROUND: Warts are a common dermatologic problem. Treatment is painful, prolonged, and can cause scarring.

OBJECTIVE: To evaluate topical zinc oxide for the treatment of warts.

METHODS: This was a randomized, double-blind controlled trial of 44 patients. Twenty-two patients were given topical zinc oxide 20% ointment, and the other 22 received salicylic acid 15% + lactic acid 15% ointment twice daily. All patients were followed up for 3 months or until cure, whichever occurred first. All patients were observed for side-effects.

RESULTS: Sixteen patients in the zinc group and 19 in the salicylic acid-lactic acid group completed the study. In the zinc oxide-treated group, 50% of the patients showed complete cure and 18.7% failed to respond, compared with 42% and 26%, respectively, in the salicylic acid-lactic acid-treated group. No patients developed serious side-effects.

CONCLUSION: Topical zinc oxide is an efficacious, painless, and safe therapeutic option for wart treatment.

http://www.blackwell-synergy.com/doi/ab ... 06.03138.x