Docstoc

Wart

Document Sample
Wart Powered By Docstoc
					Wart
                      Wart
   Wart or verrucae
   Benign proliferations of the skin and mucosa
    that are caused by infection with
    papillomaviruses
   Very common infection of skin and mucosa of
    children and adults
                        Wart
   Human papillomaviruses (HPVs)
   Subset of which are associated with cervical,
    penile, anal, and other epithelial malignancies
                Clinical finding
   Cutaneous manifestations are varied
   Scaly, rough, spiny papules or nodules
   Filiform, cutaneous horns
   Flat wart : slightly elevated, flat-topped papules
    with minimal scale
               Clinical finding
   Plantar and palmar warts : thick, endophytic, and
    hyperkeratotic papules, which may be painful
    with pressure
   Punctate black dots after shaving away of the
    outer keratinous surface represent thrombosed
    capillaries in the papilloma
                   Diagnosis
   Clinical appearance and history of acquired,
    slowly enlarging papules
   Histologic examination can be used to confirm
    the diagnosis
Differential diagnosis
Differential diagnosis
               Complications
   Specific PV genotypes have oncogenic potential
   SCC, cervical cancer, penile, vulvar, anal and
    oral carcinoma
                   Treatment
   Physical destruction of the infected cells
   Cryotherapy
   Curetted or surgically excised
   Electrodesiccation
   Laser
   Chemotherapeutic agents : topical podophyllin,
    topical 5-fluorouracil, intralesional bleomycin
                     Treatment
   Caustics and acids : salicylic acid, lactic acid,
    trichloroacetic acid
   Immunotherapy
Corns and Calluses
             Corns and calluses
   Result from prolonged application of excessive
    mechanical shear or friction forces to the skin
   Induced hyperkeratinization, which leads to a
    thickening of the stratum corneum
             Corns and calluses
   If the abnormal forces are distributed over a
    board area ( more than 1 cm2 ) a callus
    develops
   A corn will form if the same forces are applied
    to a focus location, with the lamellae of the
    stratum corneum becoming impacted to form a
    hard central core known as the radix or
    nucleus
               Clinical findings
   Painful symptoms often described as burning
   Keratotic papules and plaques
   Pedal locations, corresponding to a structural
    deformity or biomechanical fault
Treatment
                  Prevention
   Reducing or eliminating the mechanical forces
   Alter shoe styles and osseous architecture
Hypertrophic scars and
       Keloids
    Hypertrophic scars and keloids
   Uncontrolled synthesis and excessive deposition
    of collagen at sites of prior dermal injury and
    wound repair
   Often occur after local skin trauma or
    inflammatory skin disorders (acne, bites,
    abscess)
    Hypertrophic scars and keloids
   Keloids : extends beyond the borders of the
    orginal wound, does not regress spontaneously,
    grows in a pseudotumor fashion with distortion
    of the lesion, and tend to recur after excision
    Hypertrophic scars and keloids
   Hypertrophic scars : confined to the borders
    of the original wound and most of time retain
    their shape
    Hypertrophic scars and keloids
   Predilection areas with increased tension :
    shoulders, sternum, manible, arms
                   Treatment
   Intralesional steroids : triamcinolone
   Other injectable treatment : bleomycin, 5-
    fluorouracil, tacrolimus, interferon
   Laser
   Self adherent soft silicone dressings
   Radiation
Miliaria
                      Miliaria
   Results from disruption of sweat ductal integrity
    with consequent sweat secretion into layers of
    epidermis
   Facilitating factors : UV light, resident organisms
    on skin, repeated sweating
                    Miliaria
   Subdivided into 4 groups
    1. Miliaria crytallina
    2. Miliaria rubra
    3. Miliaria pustulosa
    4. Miliaria profunda
Erythema nodosum
            Erythema nodosum
   The most common type of septal panniculitis
   Reaction pattern to a variety of etiologic agents
            Erythema nodosum
   May occur at any age, but most cases appear
    between the second and fourth decades of life
   Much more common in woman than in men
             Erythema nodosum
   Sudden onset of symmetric, tender,
    erythematous, warm nodules and raised plaques
    with bilateral distribution, usually on the anterior
    aspect of the lower extremities
   Ulceration is never seen
   Heal without scar
Erythema nodosum
            Erythema nodosum
   Associated symtoms : fever, fatigue, malaise,
    arthralgia, headach, abdominal pain, vomiting,
    cough, diarrhea
   The eruption generally lasts from 3 to 6 weeks,
    and recurrences are frequent
                  Treatment
   Direct toward the associated disorder
   Spontaneous regression within a few weeks
   Bed rest
   Aspirin, NSAIDs, saturated solution of
    potassium iodide
   Systemic corticosteroids (rare)
Discoid LE
DLE
                       DLE
Classic discoid lupus erythematosus.
Typical : early erythematous plaque
          demonstrating hyperkeratosis
          accentuation of follicle orifices
DLE
DLE
DLE
DLE

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:40
posted:4/11/2011
language:English
pages:57