Our topic here is a verruca.
You’ll know this as being warts.
And with your wart, you should be
thinking about your virus, HPV.
We have verruca vulgaris, HPV 2
You have verruca plana,
which is HPV 3 and 10.
HPV 1, such as verruca plantar.
And if it’s condyloma, the one
that you’re oh so familiar with,
you’re referring to your low
strain of HPV 6 and 11.
let me show something to you in which
you may or may not be familiar with
that all of these HPVs that I’m
showing you here are low strain.
And each one of these HPVs are then given
you a different type of wart presentation.
Verruca vulgaris, verruca plana, verruca
plantar, and condyloma acuminata.
The genital warts with high
risk of malignancy, of course,
then referring to your
HPV 16, 18, 31, 33.
And verruca vulgaris,
very common in kids.
And the vulgaris is the one in
which it’s associated with HPV 2.
And if it helps you, think
about terrible twos,
may result in verruca vulgaris.
It can be severe and recalcitrant
meaning to say your individuals
who might have HIV
or who are on
may present with HPV that is not
responding to medications, recalcitrant.
And what are you going to find?
Well, you know what warts look
like, I’ll show you a picture.
It varies with location
with HPV type.
Here for example, in the vaginal area,
I’m showing you what’s known
as your HPV 6 and 11.
This will be low strain type of HPV
and this then refers to as being
your condyloma acuminata.
So morphology or pathology,
what are we looking for?
So obviously, this is
If anything, there is
In other words,
In addition, there’s
papillomatosis and hyperkeratosis.
And here will be hypergranulosis
in the epidermis.
And this will be opposite –
Give me one condition
that we’ve talked about
in dermatology in which the granular
layer is actually absent or thinned out.
Now, if you would tell me by
reflex that this was psoriasis.
But in this case,
referring to your wart.
Dilated and tortous
vessels in the dermis.
Obviously because of
thickening taking place.
Now, verruca in children:
Most warts will resolve with time.
Treatment focused on your
And remember that destruction
may be taking place
and so therefore, the areas
that you’re worried about
would include some of your
cantharidin areas -- podophyllin,
or you have your cantharidin, and
LN2, destruction taking place.
the drug or management
that you want to know
will be Imiquimod cream
approved for genital warts.
Treatment can be problematic in
immunocompromised patient as we had referred to
and please keep in mind for
microbiology that obviously here,
with warts and HPV, and especially
the higher strain and such
that you have vaccinations
that are now available
so that you can then
combat some of the HPV,
and of course referring
to your Gardasil.
Differential diagnoses for verruca:
Wherever verruca may be located, it
might look like squamous cells cancer.
However, in squamous cell
cancer, there’s usually –
There is going to be history of sun-exposed
area, usually elderly individuals.
And generally larger with squamous cell
carcinoma as I will show you pictures of.
And another important one
is called a corn or clavus.
And this occurs over the
pressure area versus verruca,
predisposed by pressure.
It does not interrupt
natural skin lines.
In other words, referring to
as being your dermatoglyphs.
And do not contain central
Other differentials, as soon as you
hear the term seborrheic keratosis,
you should be thinking
about that greasy,
yellow, maybe perhaps
waxy type of appearance.
If it was an infant, then we refer
to this being a cradle cap.
And if it’s condyloma lata,
not to be confused with condyloma
acuminata, which is the verruca.
Lata would be referring to
your secondary syphilis.
And your condyloma lata,
here the serologic test obviously
would demonstrate the organism
and may be perhaps having
positive for RPR for syphilis.
Usually where you would find this would
be mostly in the areas that are moist,
and this would be the lata.
Make sure that you take a moment
and you have already properly organized
your lata as being part of your syphilis
or if you want, maybe it’s
silly, “I want a lata syphilis.”
And not that anyone
really wants that.
Or you’re accumulating,
your condylama accumulating or acuminata,
koilocytes, if that helps you.
Just quick little revisions of micro that
you’ve looked at some point in time.