Skinrepublic

 Hi Dr. Jen!

   I would like to ask what the best solution or the medicine for "kulugo". Is it contagious?

   Analee

  Dear Analee,

   The colloquial term for wart is "kulugo" or "konggo". It is caused by a virus called human papillomavirus. This is considered highly contagious since the virus can survive for a long time without a host. We can get it from contaminated showers or swimming pools. We can get it from a pedicure when manicuristas use unsterile instruments. We can even get it from having a simple foot spa. 

   In our setting, the best therapy is a one-time removal through cautery with curettage. Depending on the number and size of "kulugo", this could take from 5 minutes to 30 minutes. This takes longer for the dermatologist and requires skill; but if she does a thorough job, one session is all it takes. If your dermatologist is PDS trained, you can be assured that she will do a satisfactory job!If the wart is located on the nails, recurrence is common. For this type of location, intralesional therapy is better.

   However, if procedure time is of the essence, using liquid nitrogen or cryosurgery is the quickest. It only takes a couple of seconds but will necessitate more than one session. Liquid nitrogen is not easily available in our setting; hence, may cost more.

   Other methods also include laser (not available here), applying keratolytics such as trichloroacetic acid (will need a lot of sessions in the span of at least 3 months) and surgery.

   Autoinoculation, which means you can infect other parts of your body, is very likely. I hope you decide to have it removed as soon as possible.Good luck!

Dear Dr. Jen,

   Why do I have white spots on my skin? The doctor said I have a fungal infection and gave me sulfur soap. The problem persists even if I've been using the soap for a long time. Please help me get rid of this.

   Marv

   Dear Marv,

   The white spots may either be a couple of things: vitiligo, postinflammatory hypopigmentation, pityriasisalbaor pityriasisversicolor. If the doctor did in fact take some skin scrapings and under the microscope discovered some hyphae and spores, then it is indeed fungus or pityriasisversicolor.

   What worries me is the chronic use of sulfur soap. Though it can help eliminate some of the fungus, it can also be irritating to both normal and inflamed skin. A more targeted solution can be to apply anti-fungal creams only on the affected areas. If the involved area is too vast, anti-fungal shampoos lathered for at least 5 minutes can be another option.

   The best solution at this point is to have it checked again. Perhaps you have been using the sulfur soap too long.   Have the lesions assessed by your PDS derma. You may not even need treatment anymore. It takes several months, even up to 8 months, for complete pigmentation to take place even if the fungus is already gone.