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Hello,

I have a patient who has had a verruca for over 5 years and is wanting treatment to remove the verruca.

I understand a lot of the treatment is not suitable right now but is there any issue with me removing the hard skin in the surrounding areas and making the verruca bleed?

She also asked me whether it is advisable to continue breastfeeding given the fact that she has an HPV infected foot.

What advice would you suggest?

Thanks,
Mia

 

Hi Mia,

My advice would be to make the lesions comfortable, as the overall immune system is altered (not supressed) during pregnancy. Whether the patient achieves this via occlusion (a sticky skin tape to trap TEWL and overhydrate the dried out corneocytes to render a hard lesion, soft = reduction in pain. This is not a proven treatment for resolution though) or by sharp debridement is up to the patient. I wouldn't make the lesion bleed though - there is no evidence that debriding VPs `to bleed` has any benefit to the patient and is potential portal of entry for other pathogens.

I certainly wouldn`t recommend to cease breast feeding due to having a benign, harmless lesion on the foot - but if she wants to try more aggressive treatments post partum, then she must ensure they are not contraindicated (eg Efudex).

Cheers,
Bel

 

T

Thank you, Bel. By pathogens do you mean the virus itself or other bacteria that could enter the foot via the bloodstream?

 

I mean secondary bacterial infection.