[S2E2] Warts And All ((TOP))

"'Warts and All'" is the second episode of the second season and the fifteenth overall, of the horror black comedy series Scream Queens. It was directed by Bradley Buecker and written by series co-creator Brad Falchuk. It premiered on September 27, 2016 on Fox Broadcasting Company. The episode centers on Chad's attempt to win Chanel back and facing competition from Dr. Brock. Meanwhile, Chanel #5 finds love with a patient with severe warts around his body. The episode was watched by 1.70 million viewers and received positive reviews from critics.

[S2E2] Warts and All

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Chanel #5 (Abigail Breslin) is being interrogated by a detective regarding Catherine Hobart's decapitation. She is desperate because nobody believes her, especially Chanel (Emma Roberts) and Chanel #3 (Billie Lourd). Meanwhile, a new patient with a Neurofibromatosis type I, Tyler (Colton Haynes), is being admitted into the hospital, where Dr. Brock (John Stamos) admits that they have a problem: there is a device that could help remove his warts, but it is expensive and the hospital does not have it yet, which makes Tyler desperate. Zayday (Keke Palmer) grows suspicious that Dean Cathy Musnch (Jamie Lee Curtis) hired the Chanels to get rid of them one by one, so she enlists Chamberlain (James Earl) to investigate why Cathy built a hospital in the first place. Later, Chanel and Dr. Brock go on a movie date, where all of a sudden his hand uncontrollably grabs Chanel's breast and grips another man's popcorn. Unaffected, Chanel is smitten and they proceed to kiss.

Tyler and Chanel #5 get closer as he comforts her, where she tells him she is depressed because of the Chanels' treatment to her and how she is not capable of getting a boyfriend. As a sympathetic Tyler reveals his photo before he was plagued by warts, Chanel #5 is stunned to see how handsome he was and decide to raise funds for his surgery. Chanel and Chanel #3 mock #5's fund raising video and tell her that as soon as Tyler is healed, he will feel the need to date her out of pity, while #5 is unsure. While at dinner together, Chanel #5 admits that she likes Tyler's personality despite his warts. She suddenly goes into a rampage when two guys insults Tyler. After calming down, she apologizes to him for being uncontrollable but Tyler is impressed. As they grow closer, Chanel seemingly congratulates #5 for being able to look into someone's soul rather than their ugly appearance (she was actually congratulating Tyler, instead) and announces she manipulated Chad to donate money for Tyler's surgery. The new couple are facetiming before his supposed surgery, but after it ends, #5 discover that his surgery is not scheduled that day and tells the Chanels about it. In the surgery room, Tyler is shocked to see the Green Meanie instead of the surgeons and the Green Meanie burns him with the laser that would be used for his surgery. The Chanels arrive too late; he is dead. As Chanel #5 mourns his death, Chanel states that they have another serial killer in their hands.

In an examination room, Tyler, the new patient, responds to Dr. Brock's question that his warts started appearing about two years ago. Chanel suddenly stands up and moves the overhead lamp above Tyler, asking if he ever thought of popping those. Zayday quickly moves the lamp and angrily tells Chanel she won't be demeaning another patient. Chanel denies it and instead feels confident to say anything since she solved Catherine's condition. The Chanels proceed to compare Tyler to a toad until they are stopped by Zayday. Still, Tyler answers Chanel in that he tried popping them and it didn't work. He was diagnosed with neurofibromatosis type 1, a genetic disorder. Dr. Brock proceeds to stand up and announces there is some bad news and good news. The good news is there is a machine CO2 laser that can painlessly remove the tumors; bad news is that the hospital doesn't have one. Tyler protests that he doesn't have money. He stands up, uttering that he's a monster; his life is ruined and only the team can help him.

Back at the hospital, Tyler sits to comfort a depressed Chanel #5. She tells him her first boyfriend, Clarence, was imaginary and broke up with her before her high school graduation. She's upset that the other two Chanels are spreading lies about her again and have boyfriends already while she can't get a boy to look at her. Tyler sympathizes with her; it's been a long time since he talked with a girl. He takes out his phone and shows her a picture before his warts grew; she's stunned as she realizes he was super hot. Suddenly, she declares she'll help him find the money for his laser surgery, though she has no idea how.

Chanel #5 and Tyler are out in a diner. #5 is upset about how the other Chanels treat her and no one believes she was attacked. Tyler thinks they can help find proof she was. Suddenly, Chanel admits she likes Tyler's personality and doesn't care about his warts. Two guys in the next booth, however, stand up and mock his appearance. #5 explodes: She smashes her plate against one of them and hits down the other, proceeding to kick off them and screams Tyler has a beautiful soul and that she does not have teeth in her vagina. When she calms down, she apologizes to Tyler and admits she hasn't been taking her meds. Tyler, however, is impressed.

Transmission of warts occurs from direct person-to-person contact or indirectly by fomites. Swimming pools and bathrooms are common areas for the spread of warts if the skin is macerated and touches rough surfaces.20 Once HPV has infected the skin, autoinoculation can occur by scratching, shaving or traumatizing the skin.22,23

Patient compliance with salicylic acid treatment is extremely important. The wart(s) should be soaked in warm water for 5 minutes before debridement of the dead, hyperkeratotic tissue with an emery board or pumice stone. The salicylic acid preparation should then be applied to the debrided wart.93 Salicylic acid liquid should be applied every day, and patches must be reapplied every 48 hours.22,23 Acids are particularly well suited for use in children, but precautions should be taken to prevent them from putting the treated area in their mouths. Acids are also appropriate for plantar warts and sensitive body parts where cryotherapy would be painful.22,23 Salicylic acid has been applied to plantar warts with some success via iontophoresis.77,96

Cryotherapy techniques can vary in application mode, freeze times and intervals between treatments. Liquid nitrogen cryotherapy can be performed with a spray gun or cotton wool bud. Wart cure rates after 3 months with treatments every 2 weeks have been reported to be 47% for cotton wool bud and 44% for spray gun; this difference is not significant.93 Warts present for 6 months or less had a greater chance of clearing (84%) within the 3 months compared with warts present for more than 6 months (39%).93

In a study of a double freeze-thaw technique versus a single freeze technique, it was found that there was no significant difference for cure rates at 3 months in using either technique for hand warts, but the double freeze-thaw technique may have been more effective for plantar warts.100 Even with paring, callus formation over warts may serve as a thermal insulator and reduce the effect of cryotherapy to below that required to induce even minimal cell damage.100

An aggressive cryotherapy (10 second) was significantly more effective (52% cure rate) than gentle cryotherapy (brief freeze) (31% cure rate) when data from four trials were pooled.19 However, pain and blistering occurred in 64 of 100 (64%) participants treated with the aggressive regimen compared with 44 of 100 (44%) treated with the gentle regimen.19 The optimum number of treatments for warts on the hands and feet in a large population of adults and children was examined by only one trial that demonstrated no significant benefit to prolonging cryotherapy after 3 months (about four freeze treatments).19

A double-blind, placebo-controlled study of warts recalcitrant twice to conventional treatments compared one to two intralesional injections of bleomycin to injections of normal saline. Plantar warts (60%), periungual warts (94%) and warts elsewhere on the extremities (95%) were cleared.178 The success of bleomycin treatment can be technique-dependent.179 Using a bifurcated needle has been reported to improve outcome.180,181 One study achieved a 92% cure rate of 258 warts with only one treatment of bleomycin using a technique of multiple wart punctures with a bifurcated needle.180 The bifurcated needle puncture technique required 0.001 units of bleomycin compared to 0.2 units injected intralesionally under the base of a wart. Only the soft epidermis comes in contact with the bleomycin avoiding dermal exposure.180 Another technique is to apply the bleomycin solution by drops onto the wart and then prick the solution into the wart using a 28-guage lancet needle. This has resulted in a 92% clearance rate.182 Others have used modified tattooing devices with some success.172

Podophyllin resin has been used mostly in the treatment of anogenital warts. A 1990 study demonstrated a 41% complete clearance rate for patients who received up to six weekly treatments for external genital warts, but only a 17% clearance at 3 months.197 Similarly, a 1991 study demonstrated a 45% clearance rate of anogenital warts at 3 months with 73% remaining clear at 9 months. This outcome was compared to a 23% clearance rate with subcutaneous interferon-α2a at 3 months with 77% remaining clear at 9 months.198 An advantage to podophyllin treatment is that it can be self-administered with greater patient convenience and cost effectiveness.199

In studies conducted between 1969 and 1975, podophyllin treatment was shown to have an 81% cure rate for simple plantar warts (comparable to an 84% cure rate for a paint containing salicylic and lactic acids).97

In 1973, Lewis first reported immunotherapy using dinitrochlorobenzene (DNCB) for common warts.215 Two randomized, controlled trials have compared DNCB to placebo with results demonstrating 80% clearance of warts with DNCB and 38% clearance with placebo.56,102 DNCB is mutagenic, so it is no longer used in clinical settings.215 041b061a72