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 subsequent treatment of these 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 the 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 between people by contact (through infected cells).The most favorable environment for virus transmission will be a warm, 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 show any clinical manifestations.A failure in 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, joint arthritis, flat feet);diseases that disrupt the trophism of the foot tissue (atherosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), injuries to the surface of the foot.
Manifestations of a plantar wart
Often, a plantar wart is round or oval in 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 usually stays 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 grayish yellow.In the center, on the surface of the plantar wart, crater-like depressions are sometimes noted.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 area of skin a mosaic pattern, which is why they are called “mosaic warts.”
Plantar warts may go away on their own.On the skin of the foot, under these conditions, they disappear without a trace.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 sharp pain caused by pressure or friction from the wart on the sole of the foot.
Plantar wart diagnosis
A plantar wart usually 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 further examine the formation, the dermatologist first shaves off 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 results for HPV diagnosis and PCR 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 the wart is suspected to be malignant in nature, the patient should consult a dermato-oncologist.If any disease or deformity is detected in the foot, in this case it is necessary to consult a podiatrist.
Plantar warts are considered separately from keratoderma of the 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, make it possible to distinguish between 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, are painless and have a positive RPR test for syphilis.
Plantar warts treatment
Removing 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 removing warts for this reason.The use of electrocoagulation is only possible when the plantar wart is not located deeply.In this case, electrocoagulation will guarantee a trace-free cure.
Cryodestruction of a wart gives positive results, which directly depend on the qualifications of the specialist, since an excessively deep effect on the tumor can cause scarring, and an effect that is too superficial 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, as this method allows you to regulate the depth of exposure.Laser wart removal is painless and quick, and healing lasts several days.
The radio wave method, in which the tumor is cut out with a radio scalpel, can also be used to remove a plantar wart.At the same time, cauterization of the vessels occurs, which prevents the neoplasm virus from entering the blood.
Surgical removal is indicated for plantar warts that reach large sizes.The procedure is performed with a common scalpel and the use of local anesthetic.There is a possibility of complications - this is the appearance of a scar.
Plantar wart prevention
The primary prevention of plantar warts is to prevent HPV infection.It is worth paying special attention to the mandatory use of personal shoes in places such as showers, swimming pools and baths.A significant 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 with foot deformities must 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 on your feet is very dry and has cracks, in this case it is necessary to use creams that can nourish and hydrate the skin on your feet.You should also take medicated foot baths regularly.
Secondary prevention of the occurrence of plantar warts is that the patient, along with removal of the wart, also receives antiviral and immunocorrecting drugs.