A plantar wart is a benign growth on the sole of the foot or toes.Plantar warts occur in approximately 34% of noncancerous 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 yourself, 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, on the contrary, severely injured surrounding tissue can cause the appearance of neoplasms in other parts of the body.
Causes of plantar warts
Condylomas, papillomas and other types of warts (foot warts, common, thread-like, flat warts) arise as a result of infection of the human body with the papilloma virus (HPV).HPV is transmitted between people through contact (through infected cells).The most favorable environment for the transmission of the virus is 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, HPV can remain latent and not cause clinical manifestations.Failure of the immune system activates the virus and the above-mentioned formations begin to appear on the skin.
The appearance and development of plantar warts are favored by factors such as excessive dryness or sweating (hyperhidrosis) of the skin of the feet;uncomfortable, squeezing and rubbing shoes;various foot deformities (deforming arthrosis, joint arthrosis, flat feet);Diseases that disrupt the trophism of foot tissues (arteriosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), damage to the surface of the foot.
Manifestations of a plantar wart
A plantar wart often has a round or oval shape with a diameter of around 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.
The surface of the wart is initially smooth, but later the neoplasm becomes covered with layers of keratinized epidermis, the surface becomes rough and turns gray-yellow.In the middle, on the surface of the plantar wart, crater-like depressions can sometimes be seen.Black-brown spots often seen on the surface of the wart are caused by thrombosis of the surface capillaries.
In most cases, plantar warts are isolated in nature.The formation of similar warts may be an indication that the virus has reached high activity.Several warts give the affected area of skin a mosaic pattern, which is why they are called “mosaic warts.”
Plantar warts can go away on their own.Under 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 considerable discomfort and often even stabbing pain due to pressure or friction of the wart on the sole.
Diagnosis of a 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 a callus and hyperkeratosis.For this purpose, the doctor carries out a dermoscopy.In order to better examine the development, the dermatologist first scrapes off the top layer of the calloused skin.The absence of a skin pattern on the surface of the formation and the noted symptoms of petechiae (“thrombus capillaries”) suggest a neoplasm.Positive results of HPV and PCR diagnostics 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 examination of the 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.
In Reiter's syndrome, the plantar wart is considered separately from the keratoderma of the palms and soles.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 make it possible to distinguish between a plantar wart and a keratoderma.
Plantar warts also have some similarities with palmoplantar syphilids.Syphilids are diverse in nature, have a specific ring-shaped or arcuate arrangement, are painless and have a positive RPR test for syphilis.
Treatment of plantar warts
Removing a plantar wart is complicated because, unlike other types of tumors, it grows deep into the dermis.For this reason, electrocoagulation, for example, is not always suitable for removing warts.The use of electrocoagulation is only possible if the plantar wart is not deep.In this case, electrocoagulation ensures healing without a trace.
Cryodestruction of a wart gives positive results, which directly depend on the qualifications of the specialist, since too deep an impact on the tumor can lead to scarring, and too superficial impact can lead to recurrence of the wart.A blister that appears on the wart site after treatment with liquid nitrogen should not be injured until it heals (healing takes about a week).
Laser removal provides the best cosmetic result because this method allows the depth of exposure to be regulated.Laser wart removal is painless and quick, and healing takes approximately 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, there is a cauterization of the vessels, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is suitable for plantar warts that reach a large size.The procedure is carried out with a normal scalpel and under local anesthesia.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 wearing of personal shoes in places such as showers, swimming pools and baths.An important role in preventing the development of plantar warts in people with foot diseases is played by correct and regular care of the skin of the feet: peeling and treating the feet with softeners as well as regular pedicures.
Patients with foot deformities should use orthoses, unloading sectors and orthopedic insoles.If your feet sweat a lot, you need to use deodorizers and drying agents and choose shoes made from natural materials.If the skin of the feet is too dry and cracked, in this case it is necessary to use creams that can nourish and moisturize the skin of the feet.You should also take medicated foot baths regularly.
Secondary prevention of the appearance of plantar warts is that, in addition to removing the wart, the patient is also prescribed antiviral drugs and immune correctors.