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A plantar wart is a common wart occurring on the bottom of the foot or toes.
Also known as verucca.
Plantar warts are benign epithelial tumors generally caused by infection by human papillomavirus types 1, 2, 4, 57, 60, 63, 65, 66, and 156.
It is a small lesion that appears on the surface of the skin and typically resembles a cauliflower, with tiny black petechiae in the center.
The virus attacks compromised skin through direct contact.
The virus possibly enters through tiny cuts and abrasions in the stratum corneum.
After infection, warts may not become visible for several weeks or months.
Hard skin may form over the wart, pushing it inward.
Its color is typically similar to that of the skin.
Small black dots often occur on the surface.
There may be one or more in an area.
It may be associated with pain with pressure such that walking is difficult.
Caused by the human papillomavirus (HPV).
A break in the skin is required for infection to occur.
Risk factors include: communal showers, prior warts, and poor immune function.
Diagnosis is typically clinical.
Differential diagnosis:
Callus
molluscum contagiosum
squamous cell carcinoma
Treatment is only needed if it is causing symptoms.
Salicylic acid, cryotherapy, surgical removal are the choices.
The skin over the lesion should generally be removed before treatment.
In about a third to two thirds of cases they go away without specific treatment.
It may take a couple of years to resolve.
Children and young adults are most often affected.
It can be painful.
It may spread through autoinoculation, by infecting nearby skin or by infected walking surfaces.
Plantar warts may fuse or develop into clusters called mosaic warts.
Pinpoint bleeding may occur when they are irritated.
Plantar warts occur on the soles of feet and toes.
Plantar warts are often similar to calluses or corns.
Feet are covered in skin striae, which are go around plantar warts.
Lesions that are not a plantar wart, the striations continue across the top layer of the skin.
Plantar warts tend to be painful on application of pressure from either side of the lesion, rather than direct pressure.
Calluses tend to be painful on direct pressure.
Prevention involves avoiding direct contact that can spread HPV with infected surfaces which include: changing rooms, 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
Wart lesions are contagious, and should be covered with adhesive bandage while swimming and using flip-flops when using communal showers and no
Sharing of towels.
Plantar warts are not prevented by inoculation with existing HPV vaccines because the warts are caused by different strains of HPV.
Treatment:
Over the counter salicylic acid.
Second-line therapy-Cryosurgery, intralesional immunotherapy, or pulsed dye laser therapy.
Third-line therapy Bleomycin, surgical excision
Salicylic acid treats of warts by keratolysis.
Salicylic acid involves the peeling away of dead surface skin cells.
Daily treatment with salicylic acid for 12 weeks leads to a complete clearance of warts in 10-15% of the cases.
Topical formic acid treatment for plantar warts, causes the body to reject the wart.
Intralesional injection of antigens such as mumps, candida or trichophytin, may trigger a host immune response to the wart virus, resulting in wart resolution.
Liquid nitrogen and similar cryosurgery methods, is a common surgical treatment which acts by freezing the external cell structure of the warts, destroying the live tissue.
Electrodesiccation and surgical excision, which may produce scarring.
Laser surgery is expensive and painful, but may be necessary for large, hard-to-cure warts, and is a last resort.
Cauterization may be effective as a prolonged treatment risks scarring or keloids.