Common Drugs and Medications to Treat Verruca Plana
Common warts are caused by human papillo-maviruses of different biological types (Figures 5.16-5.18). They are benign, weakly infective, fibre-epithelial tumours with a rough keratotic surface. Usually periungual warts are asymptomatic, although fissuring may cause pain. Subungual warts initially affect the hyponychium, growing slowly toward the nail bed and finally elevating the nail plate. Bone erosion from verruca vulgaris occasionally occurs although some of these cases may have been keratocanthomas, since the latter, epidermoid carcinoma and verruca vulgaris are sometimes indistinguishable by clinical signs alone. Acquired periungual fibrokeratoma Periungual fibroma (tuberous sclerosis) Within the nail fold Myxoid pseudocysts Tendon sheath giant cell tumour On the nail folds and nail walls Verruca vulgaris
Widespread and persistent dissemination of flat warts (verruca plana), sometimes for decades, which can progress to malignancy. Often associated with HPV types 5 and 8. Found particularly in immuno-suppressed persons, e.g. AIDS patients. Synonym Lewandowsky-Lutz disease.
(CRPV) Type species of the genus Papillomavirus. The 72 capsomeres are arranged with a left-hand skew lattice. A natural infection of cottontail rabbits, Sylvilagus floridanus. Domestic rabbits, Oryctolagus, and several species of Lepus can be infected by scarification into the skin. Skin warts appear and regress but may become malignant, more often in domestic rabbits than in cottontails. Serial propagation in cell cultures has not been reported. Although rabbit erythrocytes adsorb the virus they are not agglutinated.
Verruca vulgaris (common warts) are caused by human papillo-maviruses 1, 2, 3, 4, 5, 8, 11, 16, and 18, as well as others, with the highest percentage by type 4. Warts are found most often on the fingers, arms, elbows, and knees and are much more numerous in the immunosuppressed patient. Treatment modalities have been the same as for condyloma acuminata, with the addition of topical cidofovir and hyperthermia. Therapy should be planned based on the location, extent, and size of the lesions. Not all lesions need treatment. Early dermatologic referral is needed for those lesions that appear to be advancing rapidly as certain papilloma viruses (16, 18, 31, 51, 52, 56) have been associated with squamous cell carcinomas of the skin and cervix. A and B, Verruca vulgaris of the finger and knee. Note the large size and multiple warts. C, Verruca planae, flat warts at multiple locations of the hand, also often seen on the face.