A supplement to Pediatric News supported by an unrestricted educational grant from Valeant Pharmaceuticals International. This supplement was jointly sponsored by Excerpta Medica, Inc., an ACCME accredited provider, and Pediatric News.
The articles in this supplement are based on clinical dialogues with the faculty.
To view the supplement, click the image above. To take the CME test, download and print out the PDF file, and follow the test instructions on page 8.
Faculty
Bari B. Cunningham, MD
Assistant Clinical Professor of Pediatrics and Medicine (Dermatology)
University of California at San Diego
Director, Dermatologic Surgery
Children's Hospital and Health Center
San Diego, Calif. Funding: Valeant Pharmaceuticals International. She discusses the unlabeled use of 5% 5-fluorouracil (5% 5-FU) for warts as well as other unlabeled alternatives including cantharidin, squaric acid, and diphency-clopropenone.
Nanette B. Silverberg, MD
Director, Pediatric Dermatology
St. Luke's-Roosevelt Hospital Center
New York, NY
Assistant Clinical Professor of Dermatology
Columbia College of Physicians and Surgeons
New York, NY Funding: Ferndale Laboratories, Inc. She discusses the unlabeled use of 5% 5-FU, imiquimod, liquid nitrogen, duct tape, pulsed-dye laser, and carbon dioxide laser as wart therapy in children. She also discusses the investigational use of 5% 5-FU for wart therapy in children.
Target Audience
This activity has been developed for pediatricians, family physicians, and other health care professionals involved in the diagnosis, treatment, and long-term management of children with warts.
Educational Needs
Warts are caused by various subtypes of the human papillomavirus (HPV) that may occur anywhere on the body. Common warts (verruca vulgaris) typically present on the hands, feet, elbows, knees, and face. Condylomata acuminata (genital warts) may occur on the genitals and in the general diaper area, and may—but do not necessarily—indicate the presence of sexual abuse. A small number of the HPV subtypes have malignant potential, especially in immunocompromised children. Although warts resolve spontaneously in up to two thirds of cases, many patients and their parents prefer to have treatment rather than wait for possible spontaneous resolution. Pediatricians and family physicians need up-to-date information on the relatively painless topical treatments available for wart removal in children that are appropriate for the primary care office. Because up to one third of treated warts resist therapy, primary care physicians also need to be aware of the range of options that may be used by dermatologists to whom they refer patients when topical therapies fail, or when the characteristics of a wart indicate that a biopsy may be necessary.
Learning Objectives
By reading and studying this supplement, participants should be able to:
• Summarize the modalities currently available for the treatment of warts in children, and list the advantages and disadvantages of each.
• Describe the steps that can be taken to minimize pain when treating children for warts.
• List the indications for referring a child with warts to a dermatology specialist.
Accreditation
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Excerpta Medica, Inc., and Pediatric News. Excerpta Medica is accredited by the ACCME to provide continuing medical education for physicians.
Excerpta Medica designates this educational activity for a maximum of 1 category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.
