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See Latest ArticlesExacerbation of asymptomatic flat facial lesions
The Clinical Advisor, 07/24/09
Burkhart CG – A 22–year–old woman presented with a four–month history of numerous slightly elevated, smooth bumps on her face. Although the papules were asymptomatic, they had spread over the past two months. The patient had used a vitamin C lotion and a three–step acne therapy containing benzoyl peroxide (Proactiv Solution) without success. She also had tried removing the lesions with a Buf–Puf facial sponge. Although she assumed they were benign, she complained that they were becoming more difficult to conceal with makeup...This patient had flat warts, or verruca plana, viral–induced, slightly elevated flat–topped papules, 2–4 mm in diameter, with minimal scale. As for OTC products, keratolytics with salicylic acid are available in the form of solution and pads. These cause chemical debridement of the wart's keratotic surface and minimal reduction of lesion size (they also cause a white discoloration). Products containing dimethyl ether and propane are available, but they have had limited success clinically. Topical cantharidin produces local epidermal necrosis. Responses can vary, and some individuals experience scarring. Podophyllin is another topical modality; however, it tends to be beneficial only for mucosal lesions. Cryotherapy using liquid nitrogen is ablative and, for many patients, offers a good balance of efficacy and side effects.
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