Monthly Archives: August 2016
Monthly Archives: August 2016
Common warts are also called verruca vulgaris. Other names used in the literature are plane juvenile warts; periungual warts; subungual warts; plantar warts; verruca; verrucae planae juveniles; filiform warts. These are benign (non-cancerous) painless growths which can appear on the skin or mucosa. The appearance of the wart is rough and can be flat or elevated out growth from the skin or mucosa. Common locations are the mucocutaneous surface of hands, face, neck, chest, feet, genitals and around the anus. The hands are particularly susceptible to being infected. Most of the warts resolve spontaneously but for those that persist there are a range of treatments available. Warts are more common among children and adolescents but can affect older persons.
Warts are named and classified based on where they appear. Some types of warts are spread through direct contact with the HPV on infected surfaces, skin contact with the wart or during sexual intercourse.
Types of warts include the following:
These are frequently seen on the hands as a single wart or clusters of warts. Elsewhere the warts tend to be flat and are generally found on the face and forehead.
Warts in the genital and pubic area are called genital warts. The warts can also occur on the inner thighs, in the area between the thighs, inside the vagina, anal canal as well as around the anus. These are sexually transmitted.
These warts which occur on the soles of the feet are more common in adolescents and can be very painful resulting in difficulty walking and running. Communal areas such as locker rooms are notorious for spreading the viral verruca infection.
Warts under the nail are subungual. When they appear around the fingernails or toenails they are called periungual warts.
The health care provider can examine your skin to diagnose warts. In some instances it may be necessary to do a skin biopsy to confirm the diagnosis of a wart. The biopsy can also differentiate common warts from skin cancer. Plantar warts can have the appearance similar to corns and calluses.
Warts are caused mainly by viral infections. Many of the viruses are part of the papovavirus group. Of this group the human papillomavirus HPV is responsible for the common localized skin wart infection. HPV can cause cancerous growths.
An infection can occur if an uninfected person is exposed to a surface such as the floor of a communal shower or locker room where the virus exists. Through an abrasion or cut on the skin or mucosa, the virus enters at the site resulting in the skin changes over time. It can take weeks or even months for a wart or verruca to appear after the initial infection. Symptoms include:
Certain warts have an increased risk of cancer (cervical, penis mouth and throat etc.) and hence the importance of visiting the doctor who is able to determine this.
Many patients will consult with the doctor or podiatrist (chiropodist) about the wart because they find it unsightly. Also with the increased public awareness of skin cancer there is anxiety to have the growth examined by the health professional. Some common warts will resolve spontaneously. It is important for patients to be cautioned not to attempt to remove the wart by burning, cutting, tearing or picking at it. This could result in a spreading of the infection and a worsening of the problem.
Minor surgical procedures
Treatment of genital and anal warts
A Word of Caution
Call your health care provider if:
There are persons who will try home remedies and homeopathic solutions. Do not delay to have a health professional examine and treat appropriately the warts especially the anogenital types.
1. Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 12.
2. Kirnbauer R, Lenz P. Human papilloma viruse. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia
3. [HTML]Self-administered topical 5% imiquimod cream for external anogenital warts, L Edwards, A Ferenczy, L Eron… – Archives of …, 1998
4. Natural history of genital warts., JD Oriel – British Journal of Venereal Diseases, 1971 – ncbi.nlm.nih.gov
5. Immunological events in regressing genital warts, N Coleman, HDL Birley, AM Renton… – American journal of …, 1994 – ajcp.oxfordjournals.org
6. Latent papillomavirus and recurring genital warts, A Ferenczy, M Mitao, N Nagai… – … England Journal of …, 1985 – Mass Medical Soc
7. Communal showers and the risk of plantar warts, LW Johnson – Journal of family practice, 1995 – go.galegroup.com
8. The treatment of palmar and plantar warts using natural alpha interferon and a needleless injector, RT Brodell, DL Bredle – Dermatologic surgery, 1995 – Wiley Online Library
Sweating is a natural body function. It is through the skin that we sweat to regulate body temperature and release toxins. Normally we sweat more in response to excessive heat and this is how the body regulates temperature to cool down. Normally mild sweating occurs all over the body. Excessive uncontrollable sweating is a medical condition which affects mainly the palm of the hands, sole of the feet, underarms, groin and face. This excessive sweating is called hyperhidrosis. There is very little data to support the prevalence of this condition in the general population. We do know however that the condition of excessive sweating affects males and females of all ages. Individuals consult with health professional for remedies as the excessive sweating can affect social and intimate relationships and result in psychological issues. Let us examine the common excessive sweating complaints, causes, symptoms and treatment.
Sweaty feet also called plantar hyperhidrosis, is a fairly common condition characterized by excessive sweating on the soles of the feet. Each foot has more than 250,000 sweat glands which make the feet sweat lightly all the time. Excessive sweating results from overactive sweat (eccrine) glands. This condition can lead to other health and social problems including athlete’s foot (a fungal infection) and smelly feet due to bacterial infection of the skin. Some of the contributory factors which cause sweaty feet include:
The family doctor and podiatrist will usually suggest non-invasive treatment to minimize the sweating. Antiperspirants of prescription strength are usually recommended in the first instance. Botox injection to block nerve signals to the sweat glands is another therapy that is tried. An extreme measure is called lumbar sympathectomy which is the surgical cauterization of the nerves thereby interrupting the stimulation of the sweat glands. This treatment has yielded a success rate of over 90%.
Sweaty hand is referred to as palmar hyperhidrosis. This is the most common type of hyperhidrosis that persons will visit a doctor for medical consultations. The condition can be so severe it can prevent an individual from working. The psychological distress can result in personal and social issues for both men and women.
Everyday activities which we take for granted are challenging for persons with sweaty hands. Some of the personal embarrassments include the inability to firmly grasp objects, drive, grip a door knob, type on the computer and the inability to do other mundane activities. The emotional distress and embarrassment drives men to keep their hands in the pockets of the pants. Being told frequently how moist or wet the palms are during a handshake is a source of embarrassment and this can shake the self-confidence of persons who are otherwise interesting, pleasant and attractive. Intimate relationships can be ruined by the excessive sweating. There is nothing romantic about being touched by wet cold hands. Sweaty hands can cause high levels of anxiety, nervousness, embarrassment, distress, stress and depression.
The groin area also has clusters of sweat glands. Men in particular who have this condition are at times embarrassed by the sweating which soaks through clothing and is visible for all to see. It is also just plain uncomfortable to feel moist in and around the scrotum. Breathable fabric underwear and loose clothing help to keep the area cool. Care must be taken with personal hygiene to avoid body odor.
Excessive underarm perspiration