A plantar wart is a benign growth on the sole or toes of the foot.Plantar warts are found in approximately 34% of non-cancerous skin growths.Dermatology deals with the diagnosis and subsequent treatment of this type of neoplasms.When trying to cure a wart, it is highly undesirable to use traditional methods and try to get rid of it on your own, since a plantar wart has a root that penetrates deep into the skin and its incomplete removal can lead to secondary growth of the wart or, conversely, severely injured surrounding tissues can lead to the appearance of neoplasms in other parts of the body.
Causes of plantar warts
Condylomas, papillomas and other types of warts (plantar, common, filiform, flat) are formed as a result of infection of the human body with the papillomavirus (HPV).HPV is transmitted between people by contact (through infected cells).The most favorable environment for the transmission of the virus will be a warm and humid environment.Therefore, people often become infected with HPV in baths, saunas, swimming pools, and gyms.If the body's immunity is strong enough, then HPV can remain latent and not give any clinical manifestations.A failure of the immune system activates the virus and the above formations begin to appear on the skin.
The appearance and development of plantar warts is facilitated by factors such as excessive dryness or sweating (hyperhidrosis) of the skin of the feet;uncomfortable shoes that squeeze and rub;various deformities of the foot (osteoarthritis deformans, arthritis of the joints, flat feet);diseases that disrupt the trophism of the foot tissue (atherosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), damage to the surface of the foot.
Manifestations of a plantar wart.
Often, a plantar wart has a round or oval shape with a diameter of about 1 to 2 cm and protrudes 1 to 3 mm above the skin.The skin color of a plantar wart is usually the same, but can sometimes be pink or light brown.
At first, the surface of the wart is smooth, but then the neoplasm is covered with layers of keratinized epidermis, the surface becomes rough and changes color to yellowish-gray.In the center, on the surface of the plantar wart, crater-shaped depressions are sometimes observed.Black-brown dots, which can often be seen on the surface of the wart, are caused by thrombosis of the superficial capillaries.
Plantar warts in most cases are unique in nature.The formation of similar warts may indicate that the virus has reached high activity.Multiple warts give the affected skin area a mosaic pattern, which is why they are called “mosaic warts.”
Plantar warts can go away on their own.In such conditions, they disappear without a trace on the skin of the foot.However, because warts are often injured, they rarely go away on their own.Even if the tumor itself does not cause pain, it can still cause the patient significant discomfort and often even acute pain caused by pressure or friction from the wart on the sole of the foot.
Plantar wart diagnosis
A plantar wart often looks like a thickened stratum corneum (hyperkeratosis) or a callus.Only a highly qualified dermatologist can distinguish a wart from calluses and hyperkeratosis.To do this, the doctor performs a dermoscopy.To better examine the formation, the dermatologist first scrapes the top layer of keratinized skin.The absent skin pattern on the surface of the formation and the identified symptoms of petechiae (“thrombosed capillaries”) speak in favor of a neoplasm.Positive HPV diagnosis and PCR results confirm the fact that the patient is infected.
To determine the depth of the root of a germinating plantar wart, the patient is prescribed an ultrasound of the skin formations.However, if there is a suspicion that the wart is malignant in nature, the patient should consult a dermato-oncologist.If any disease or deformity of the foot is detected, in this case it is necessary to consult a podiatrist.
Plantar wart is considered separately from keratoderma of palms and soles in Reiter syndrome.The smaller size and shape (flat, not conical) of the formations, petechiae or the so-called symptom of "thrombosed capillaries", as well as the absence of inflammatory changes around the keratinized layers of the epidermis, allow us to distinguish between a plantar wart and a keratoderma.
Plantar warts also have some common characteristics with palmoplantar syphilis.Syphilis are multiple in nature, have a specific annular or arcuate arrangement, are painless, and have a positive RPR test for syphilis.
Treatment of plantar warts.
Removing a plantar wart is complicated because it grows deep in the dermis, unlike other types of tumors.For this reason, for example, electrocoagulation is not always suitable for removing warts.The use of electrocoagulation is only possible when the plantar wart is not located deeply.In this case, electrocoagulation will ensure trace-free healing.
Cryodestruction of a wart gives positive results, which directly depend on the qualifications of the specialist, because an excessively deep effect on the tumor can lead to scarring, and too superficial an effect can lead to the reappearance of the wart.A blister that appears after liquid nitrogen treatment at the site of a wart should not be injured until it heals (healing takes about a week).
Laser removal provides the best cosmetic result, since this method allows the depth of exposure to be regulated.Laser wart removal is painless and quick, and healing lasts approximately several days.
The radio wave method, in which the tumor is removed with a scalpel, can also be used to remove a plantar wart.At the same time, cauterization of the vessels occurs, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is suitable for plantar warts that reach large sizes.The procedure is carried out with a normal scalpel and the use of local anesthetic.There is a possibility of complications - this is the appearance of a scar.
Prevention of plantar warts.
The primary prevention of plantar warts is to prevent HPV infection.It is worth paying special attention to the mandatory use of personal footwear in places such as showers, swimming pools and bathrooms.An important role in preventing the formation of plantar warts in people suffering from foot diseases is played by proper and regular care of the skin of the feet: peeling and treating the feet with emollients, as well as regular pedicures.
Patients suffering from foot deformities should use orthotics, unloading sectors and orthopedic insoles.If your feet sweat a lot, you should use deodorizing and drying agents and choose shoes made of natural materials.If the skin on the feet is too dry and has cracks, then in this case it is necessary to use creams that can nourish and moisturize the skin of the feet.It is also advisable to perform medicated foot baths regularly.
Secondary prevention of the appearance of plantar warts is that the patient, along with the removal of the wart, is also prescribed antiviral and immunocorrective drugs.