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Dermatology

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Infection

Question
3 out of 32
 

Immunomodulator used in treatment of genital warts is (AIIMS Nov 2014)



A ATRA
B Podophyllin

C Imiquimod
D Prednisolone

Ans. C
Imiquimod

1). There are many modalities available for the treatment of warts, but no Single therapy is universally effective.

2). Factors that influence the choice of therapy -- the location of the wart, extent of disease, the age and immunological status of the patient.

3). Perhaps the most useful and convenient method for the treatment of almost any location is cryotherapy with liquid nitrogen, but requires much more patient compliance. Keratolytic agents such as salicylic acid plasters or solution In genital warts, in-office application of a podophyllin solution is usually effective but may be associated with marked local reactions. Topical preparations of dilute, purified podophyllin are also available for use.

4). Topical imiquimod a potent inducer of local cytokine rel also has been approved for the use in genital warts.

5). Conventional surgical procedures may be required for recalcitrant warts; RI of warts appears to be common to all these modalities.

Therapy of Anogenital Warts

Drugs given are: Podophyllin, TCA, Imiquimod; of these the DOC is Podophyllin but Imiquimod is an immunomodulator. Podophyllin is derived from rhizomes of P. peltatum. It arrest cell growth in mitosis. It is potent irritant and teratogenic once a week application is recommended and it is to be washed of after 4-6 hrs.

Therapy of Warts

1). Topical Podophyllin (10–25%) Podophyllotoxin (0.5%)

2). Trichloroacetic acid 5-FU (5%)

3). IFN-intralesional Imiquimod

4). Surgery Curettage and cautery Cryosurgery (-196oC -àLiquid Nitogen)

5). CO2 laser Systemic IFN-Alpha, IFN-Gama (subcutaneous, low doses, cyclic therapy)

Extra Edge: WARTS (verrucae)

Types

Verruca Vulgaris / Common Warts

Myrmecia wart

Condyloma acuminata (venerals Warts)

.

MC type

Painful

. Cauliflower like growth in genitalia

.

Dorsum of hand / finger

Dome shaped papule

. Koilocytes+

Seen on soles

. Not premalignant

.

Köbner’s phenomena+

. associated with type 6 & 11

.

Treatment: Electrodesiccation /

. Common is sexually promiscuous

young adult

àHPV infect squamous epith. of both Keratinized & non keratinized surface by direct inoculation.

àHyperplasia of all layers of Epidermis+ Acanthosis+ papillomatosis.

àWart paints are most effective in plantar warts, filiform warts on scalp and beard region.

àPodophyllin is DOC for condyloma acuminate. But in pregnancy it is c/ind & trichloroacetic acid cautry is TOC.

Infection Flashcard List

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