A plantar wart is a benign growth on the sole or toes.Plantar warts are found in approximately 34% of non-cancerous skin growths.Dermatology deals with the diagnosis and further treatment of such 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 goes deep into the skin and its incomplete removal can lead to secondary growth of the wart, or, on the contrary, severely injured surrounding tissues can cause 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 papilloma virus (HPV).HPV is transmitted among people through contact (through infected cells).The most favorable environment for 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, squeezing and rubbing shoes;various foot deformities (deforming osteoarthritis, arthritis of the joints, flat feet);diseases that disrupt the trophism of 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 1-2 cm and protrudes 1-3 mm above the skin.The skin color of a plantar wart usually remains the same, but can sometimes be pink or light brown.
At first, the surface of the wart is smooth, but later the neoplasm is covered with layers of keratinized epidermis, the surface becomes rough and changes color to gray-yellow.In the center, on the surface of the plantar wart, crater-like depressions are sometimes noted.Black-brown dots, which can often be observed on the surface of the wart, are caused by thrombosis of the surface capillaries.
Plantar warts in most cases are single in nature.The formation of similar warts may indicate that the virus has reached high activity.Multiple warts give the affected area of skin a mosaic pattern, which is why they are called “mosaic warts.”
Plantar warts may disappear on their own.On the skin of the foot under such conditions they disappear without a trace.However, since warts are often injured, they rarely disappear on their own.Even if the tumor itself does not cause pain, it can still cause the patient significant discomfort and often even sharp pain caused by pressure or friction of the wart on the sole.
Diagnosis of plantar wart
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 dermatoscopy.In order to better examine the formation, the dermatologist first scrapes off the top layer of keratinized skin.The skin pattern absent on the surface of the formation and the identified symptoms of petechiae (“thrombosted capillaries”) speak in favor of a neoplasm.Positive results for HPV and PCR diagnostics confirm the fact that the patient is infected.
In order to determine the depth of the root of a germinating plantar wart, the patient is prescribed an ultrasound of skin formations.However, if there is a suspicion that the wart is of a malignant nature, the patient should consult a dermato-oncologist.If a disease or deformity of the foot is detected, in this case it is necessary to consult a podiatrist.
The plantar wart is considered separately from keratoderma of the palms and soles in Reiter's syndrome.The smaller size and shape (flat, not conical) of 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, make it possible to distinguish between a plantar wart and keratoderma.
Plantar warts also have some common features with palmoplantar syphilides.Syphilides are multiple in nature, have a specific ring or arcuate arrangement, they are painless and have a positive RPR test for syphilis.
Treatment of plantar warts
Removal of a plantar wart is complicated because it grows deep into the dermis, unlike other types of tumors.For example, electrocoagulation is not always suitable for wart removal for this reason.The use of electrocoagulation is possible only when the plantar wart is not located deeply.In this case, electrocoagulation will ensure traceless 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 treatment with liquid nitrogen at the site of a wart should not be injured until it heals (healing takes about a week).
Laser removal gives the best cosmetic result, since this method makes it possible to regulate the depth of exposure.Laser removal of warts is painless and quick, and healing lasts about several days.
The radio wave method, in which the tumor is cut out with a radio knife, 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 using a regular scalpel and the use of a local anesthetic.There is a possibility of complications - this is the appearance of a scar.
Prevention of plantar warts
Primary prevention of plantar warts is to prevent HPV infection.It is worth paying special attention to the mandatory wearing of personal shoes in places such as showers, swimming pools and baths.A significant role in preventing the formation of plantar warts for 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 orthoses, unloading sectors, and orthopedic insoles.If your feet sweat a lot, you need to use deodorizing and drying agents and choose shoes made from natural materials.If the skin of the feet is too dry and there are cracks on it, then in this case it is necessary to use creams that can nourish and moisturize the skin of the feet.You should also take medicinal foot baths regularly.
Secondary prevention of the occurrence of plantar warts is that the patient, along with the removal of the wart, is also prescribed antiviral drugs and immunocorrectors.