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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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A number of treatments have been found to be effective. A 2012 review of different treatments for skin warts in otherwise healthy people concluded modest benefit from salicylic acid and cryotherapy appears similar to salicylic acid.
The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen.
The virus is resistant to drying and heat, but killed by and ultraviolet radiation.
HPV is spread by direct and indirect contact from an infected host. Avoiding direct contact with infected surfaces such as communal changing rooms and shower floors and benches, avoiding sharing of shoes and socks and avoiding contact with warts on other parts of the body and on the bodies of others may help reduce the spread of infection. Infection is less common among adults than children.
As all warts are contagious, precautions should be taken to avoid spreading them. Recommendations include:
- cover them with an adhesive bandage while swimming
- wear flip-flops when using communal showers
- should not share towels.
Plantar warts are not prevented by inoculation with HPV vaccines because the warts are caused by different strains of HPV. Gardasil protects against strains 6, 11, 16, and 18, and Cervarix protects against 16 and 18, whereas plantar warts are caused by strains 1, 2, 4, and 63.
Another product available over-the-counter that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. In a placebo-controlled study of 70 patients, silver nitrate given over nine days resulted in clearance of all warts in 43% and improvement in warts in 26% one month after treatment compared to 11% and 14%, respectively, in the placebo group. The instructions must be followed to minimize staining of skin and clothing. Occasionally pigmented scars may develop.
Several randomized, controlled trials have found that zinc sulfate, consumed orally, often reduces or eliminates warts. The zinc sulfate dosage used in medical trials for treatment of warts was between 5 and 10 mg/kg/day. For elemental zinc, a lower dosage of 2.5 mg/kg/day may be appropriate as large amounts of zinc may cause a copper deficiency. Other trials have found that topical zinc sulfate solution or zinc oxide are also effective.
A 2014 study indicates that lopinavir is effective against the human papilloma virus (HPV). The study used the equivalent of one tablet twice a day applied topically to the cervices of women with high-grade and low-grade precancerous conditions. After three months of treatment, 82.6% of the women who had high-grade disease had normal cervical conditions, confirmed by smears and biopsies.
Studies of fat-soluble garlic extracts have shown clearing in greater than 90% of cases. The extract is applied twice daily and covered with an adhesive bandage. Improvements show within 2–4 weeks and total clearing in an average of 6–9 weeks.
Pitted keratolysis can be reduced and eventually stopped by regularly applying a liberal amount of antiperspirant body powder to the inside of the shoes and socks of the sufferer. Regular powder application will greatly reduce foot perspiration and keep the plantar surface of the foot dry therefore creating an environment hostile to the Corynebacterium.
Calluses and corns may go away by themselves eventually, once the irritation is consistently avoided. They may also be dissolved with keratolytic agents containing salicylic acid, sanded down with a pumice stone or silicon carbide sandpaper or filed down with a callus shaver, or pared down by a professional such as a podiatrist or a foot health practitioner.
Periungual warts are warts that cluster around the fingernail or toenail. They appear as thickened, fissured cauliflower-like skin around the nail plate. Periungual warts often cause loss of the cuticle and paronychia. Nail biting increases susceptibility to these warts.
Warts of this kind often cause damage to the nail either by lifting the nail from the skin or causing the nail to partially detach. If they extend under the nail, then the patient may suffer pain as a result. Sometimes periungual wart infections resemble the changes that are found in onychomycosis. In worst cases, if the infection causes injury or damage to the nail matrix, deformity in the nail may become permanent.
As with other wart types, a number of treatments are available, including laser therapy, cryotherapy, salicylic acid, and other topical treatments.
Corns and calluses are easier to prevent than to treat. When it is usually not desirable to form a callus, minimizing rubbing and pressure will prevent callus formation. Footwear should be properly fitted, gloves may be worn, and protective pads, rings or skin dressings may be used. People with poor circulation or sensation should check their skin often for signs of rubbing and irritation so they can minimize any damage.
No treatment of seborrheic keratoses is necessary, except for aesthetic reasons. Since a slightly increased risk of localized infection caused by picking at the lesion has been described, if a lesion becomes itchy or irritated by clothing or jewelry, a surgical excision is generally recommended.
Small lesions can be treated with light electrocautery. Larger lesions can be treated with electrodesiccation and curettage, shave excision, or cryosurgery. When correctly performed, removal of seborrheic keratoses will not cause much visible scarring except in persons with dark skin tones.
No curative treatment against EV has been found yet. Several treatments have been suggested, and acitretin 0.5–1 mg/day for 6 months’ duration is the most effective treatment owing to antiproliferative and differentiation-inducing effects.
Interferons can also be used effectively together with retinoids.
Cimetidine was reported to be effective because of its depressing mitogen-induced lymphocyte proliferation and regulatory T cell activity features. A report by Oliveira "et al." showed that cimetidine was ineffective. Hayashi "et al." applied topical calcipotriol to a patient with a successful result.
As mentioned, various treatment methods are offered against EV; however, most importantly, education of the patient, early diagnosis, and excision of the tumoral lesions take preference to prevent the development of cutaneous tumors.
Treatment of lesions of digital dermatitis is done by topical application of agents to the affected skin. The skin should be cleaned and kept dry prior treatment. Topical oxytetracycline (OTC) is often referred as the most reliable treatment as cows treated with OTC have a good recovery rate. Bandaging the lesion is often undertaken but there is no evidence of any benefit and bandaging can provide the anaerobic environment which supports the spirochaetes.. Systemic antibiotics are not needed.
Control and prevention of digital dermatitis relies on prompt detection, isolation and treatment of affected cattle. Group hoof disinfection can be achieved via the passage of the cows through footbaths of antimicrobial solutions. Slurry build-up should be avoided since organic matter can impair the antimicrobial efficacy of the footbath solutions. Regular footbaths should be organised, using formalin, copper sulphate or a thymol-based disinfectant. While regular footbathing can help prevent hoof infections, occasional flare-up of active M2 lesions can happen.
As the horn is composed of keratin, the same material found in fingernails, the horn can usually be removed with a sterile razor.However, the underlying condition will still need to be treated. Treatments vary, but they can include surgery, radiation therapy, and chemotherapy.
People of any age, race, or sex can fall victim to this disorder, though it is more commonly found in men. People who sweat or wash excessively tend to be prone to pitted keratolysis. The prolonged wearing of occlusive footwear, such as tight shoes or rubber boots, also makes one more susceptible. Not surprisingly, athletes and soldiers are extremely prone to this problem. Hot and humid weather is another factor for raising the risk. Those on immunosuppressive drug therapy or diabetes sufferers are also more likely to succumb to pitted keratolysis.
Seborrheic keratosis is the most common benign skin tumor. Incidence increases with age. There is less prevalence in people with darker skin. In large-cohort studies, 100% of the patients over age 50 had at least one seborrheic keratosis. Onset is usually in middle age, although they are common in younger patients too—found in 12% of 15-year-olds to 25-year-olds—making the term "senile keratosis" a misnomer.
There are several preventive foot hygiene measures that can prevent athlete's foot and reduce recurrence. Some of these include keeping the feet dry, clipping toenails short; using a separate nail clipper for infected toenails; using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry); avoiding tight-fitting footwear, changing socks frequently; and wearing sandals while walking through communal areas such as gym showers and locker rooms.
According to the Centers for Disease Control and Prevention, "Nails should be clipped short and kept clean. Nails can house and spread the infection." Recurrence of athlete's foot can be prevented with the use of antifungal powder on the feet.
The fungi (molds) that cause athlete's foot require warmth and moisture to survive and grow. There is an increased risk of infection with exposure to warm, moist environments (e.g., occlusive footwear—shoes or boots that enclose the feet) and in shared humid environments such as communal showers, shared pools, and treatment tubs. Chlorine bleach is a disinfectant and common household cleaner that kills mold. Cleaning surfaces with a chlorine bleach solution prevents the disease from spreading from subsequent contact. Cleaning bathtubs, showers, bathroom floors, sinks, and counters with bleach helps prevent the spread of the disease, including reinfection.
Keeping socks and shoes clean (using bleach in the wash) is one way to prevent fungi from taking hold and spreading. Avoiding the sharing of boots and shoes is another way to prevent transmission. Athlete's foot can be transmitted by sharing footwear with an infected person. Hand-me-downs and purchasing used shoes are other forms of shoe-sharing. Not sharing also applies to towels, because, though less common, fungi can be passed along on towels, especially damp ones.
For severe or refractory cases of athlete's foot oral terbinafine is more effective than griseofulvin. Fluconazole or itraconazole may also be taken orally for severe athlete's foot infections. The most commonly reported adverse effect from these medications is gastrointestinal upset.
There is no cure for HPV. Existing treatments are focused on the removal of visible warts, but these may also regress on their own without any therapy. There is no evidence to suggest that removing visible warts reduces transmission of the underlying HPV infection. As many as 80% of people with HPV will clear the infection within 18 months.
A healthcare practitioner may offer one of several ways to treat warts, depending on their number, sizes, locations, or other factors. All treatments can potentially cause depigmentation, itching, pain, or scarring.
Treatments can be classified as either physically ablative, or topical agents. Physically ablative therapies are considered more effective at initial wart removal, but like all therapies have significant recurrence rates.
Many therapies, including folk remedies, have been suggested for treating genital warts, some of which have little evidence to suggest they are effective or safe. Those listed here are ones mentioned in national or international practice guidelines as having some basis in evidence for their use.
Gardasil (sold by Merck & Co.) is a vaccine that protects against human papillomavirus types 6, 11, 16 and 18. Types 6 and 11 cause genital warts, while 16 and 18 cause cervical cancer. The vaccine is preventive, not therapeutic, and must be given before exposure to the virus type to be effective, ideally before the beginning of sexual activity. The vaccine is approved by the US Food and Drug Administration for use in both males and females as early as 9 years of age.
In the UK, Gardasil replaced Cervarix in September 2012 for reasons unrelated to safety. Cervarix had been used routinely in young females from its introduction in 2008, but was only effective against the high-risk HPV types 16 and 18, neither of which typically causes warts.
Verruca plana, also known as a "flat wart", is a reddish-brown or flesh-colored, slightly raised, flat-surfaced, well-demarcated papule of 2 to 5 mm in diameter. Upon close inspection, these lesions have a surface that is "finely verrucous". Most often, these lesions affect the hands or face, and a linear arrangement is not uncommon.
A recent retrospective study of all cases of Ecthyma gangrenosum from 2004-2010 in a university hospital in Mexico shows that neutropenia in immunocompromised patients is the most common risk factor for ecthyma gangrenosum.
Pustulosis is highly inflammatory skin condition resulting in large fluid-filled blister-like areas - pustules. Pustulosis typically occurs on the palms of the hands and/or the soles of the feet. The skin of these areas peels and flakes (exfoliates).
This condition—also referred to as "palmo-plantar pustulosis"—is a feature of pustular psoriasis.
The cause of cutaneous horns is still unknown, but it is believed that exposure to radiation can trigger the condition. This is evidenced by a higher rate of cases occurring on the face and hands, areas that are often exposed to sunlight. Other cases have reported cutaneous horns arising from burn scars. As with many other wart-like skin conditions, a link to the HPV virus family, especially the HPV-2 subtype has been suggested.
Wearing shoes to protect barefoot trauma has shown decrease in incidence in ainhum. Congenital pseudoainhum cannot be prevented and can lead to serious birth defects.
Digital dermatitis is a disease that causes lameness in cattle. It was first discovered in Italy in 1974 by Cheli and Mortellaro. This disease is caused by a mixture of different bacteria. Anaerobic bacteria, including spirochetes of the genus "Treponema", are found in the lesions associated with the infection. Digital dermatitis is different from foot rot in cattle and both conditions may occur concurrently.
Digital dermatitis primarily affects dairy cattle and has been known to lower the quantity of milk produced, but the quality of the milk is unaffected.
Evidence show that risk factors favouring digital dermatitis outbreaks include: poor hygiene and high humidity; introduction of infected animals; no hoof care for heifers and dry cows; high levels of chronically infected animals; insufficient or inadequate hoof trimming; soft hooves and unbalanced nutrition.
Treatments involve antibiotics that cover for "Pseudomonas aeruginosa". Antipseudomonal penicillins, aminoglycosides, fluoroquinolones, third generation cephalosporins or aztreonam can be given. Usually, the antibiotics are changed according to the culture and sensitivity result. In patients with very low white blood cell counts, Granulocyte-macrophage colony-stimulating factor may be given. Depending on the causal agents, antivirals or antifungals can be added.
Surgery will be needed if there is extensive necrosis not responding to medical treatments.