ITEMS IN AFP WITH MESH TERM:
Over-the-Counter Foot Remedies - Article
ABSTRACT: Several effective and inexpensive over-the-counter treatments are available for minor but troubling foot problems. In most cases, one week of therapy with topical terbinafine is effective for interdigital tinea pedis. Treatment of plantar warts with 17 percent salicylic acid with lactic acid in a collodion base is as effective as cryotherapy, but treatment must be sustained for several months. Toe sleeves and toe spacers can relieve pain from hard or soft corns. Metatarsal pads can relieve the pressure associated with plantar keratoses. Heel cups often can relieve pain caused by age-related thinning of the heel fat pad. Plantar fasciitis is a common cause of anteromedial heel pain caused by repetitive strain on the plantar fascia. Although the mainstay of therapy is stretching exercises, ready-made arch supports and insoles can be helpful adjuncts.
Molluscum Contagiosum and Warts - Article
ABSTRACT: Molluscum contagiosum and warts are benign epidermal eruptions resulting from viral infections of the skin. Molluscum contagiosum eruptions are usually self-limited and without sequelae, although they can be more extensive in immunocompromised persons. Spontaneous disappearance of lesions is the norm, but treatment by local destruction (curettage, cryotherapy, or trichloroacetic acid) or immunologic modulation can shorten the disease course, possibly reducing autoinoculation and transmission. Warts result from a hyperkeratotic reaction to human papillomavirus infection; nongenital warts are classified as common, periungual, flat, filiform, or plantar, based on location and shape. Warts are treated by local destruction (acids, cryotherapy, electrodesiccation-curettage), chemotherapy, or immunotherapy. The choice of treatment varies with the age and wishes of the patient, the potential side effects of the treatment, and the location of the lesions.
ABSTRACT: Cutaneous warts are a common presenting complaint in children and adolescents. Common, plantar, or flat warts are cutaneous manifestations of the human papillomavirus. The treatment of warts poses a therapeutic challenge for physicians. No single therapy has been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches are discussed to demonstrate the evidence supporting common therapies and provide a guideline for physicians. Evidence supports the at-home use of topical salicylic acid and physician-administered cryotherapy. Intralesional immunotherapy for nongenital cutaneous warts may be an option for large or recalcitrant warts.
Effective Topical Treatments for Nongenital Warts - Cochrane for Clinicians
Discrete Papules on the Thigh of a Child - Photo Quiz
Treatment of Nongenital Cutaneous Warts - Article
ABSTRACT: Numerous treatments for nongenital cutaneous warts are available, although no single therapy has been established as completely curative. Watchful waiting is an option for new warts because many resolve spontaneously. However, patients often request treatment because of social stigma or discomfort. Ideally, treatment should be simple and inexpensive with low risk of adverse effects. Salicylic acid has the best evidence to support its effectiveness, but it is slow to work and requires frequent application for up to 12 weeks. Cryotherapy with liquid nitrogen is a favorable option for many patients, with cure rates of 50 to 70 percent after three or four treatments. For recalcitrant warts, Candida or mumps skin antigen can be injected into the wart every three to four weeks for up to three treatments. More expensive treatments for recalcitrant warts are offered in many dermatology offices. Photodynamic therapy with aminolevulinic acid has the best evidence of effectiveness compared with pulsed dye laser, intralesional bleomycin, and surgical removal using curettage or cautery.
Cutaneous Cryosurgery - Article
ABSTRACT: Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign and premalignant skin conditions, and certain malignant skin conditions, with high cure rates. Cellular destruction is accomplished by delivery of the cryogen via dipstick, probe, or spray techniques. It is widely used in primary care because of its safety, effectiveness, low cost, ease of use, good cosmetic results, and lack of need for anesthesia. Cryosurgery is as effective as alternative therapies for most cases of molluscum contagiosum, dermatofibromas, keloids, and plantar or genital warts. It is a more effective cure for common warts than salicylic acid or observation. Cryosurgery is generally the treatment of choice for actinic keratosis. Contraindications to cryosurgery include cryofibrinogenemia, cryoglobulinemia, Raynaud disease, agammaglobulinemia, and multiple myeloma. Complications from cryosurgery include hypopigmentation and alopecia, and can be avoided by limiting freeze times to less than 30 seconds. Referral to a dermatologist should be considered in cases of diagnostic uncertainty or for treatment of skin cancer, which requires larger amounts of tissue destruction, resulting in higher complication rates.