Plantar Wart
Plantar Wart
A plantar wart (verruca plantaris, VP; also commonly called a verruca) is a wart caused by the human papilloma virus (HPV). It is a small lesion that appears on the sole of the foot (hence the name, from Latin planta pedis, the sole of the foot) and typically resembles a cauliflower. A plantar wart may have small black specks within it that ooze blood when the surface is cut or shaved; these are abnormal capillaries. Though the name plantar wart describes specifically HPV infection on the sole of the foot, infection by the virus is possible anywhere on the body and common especially on the palm of the hand, where the appearance of the wart is often exactly as described above for plantar warts. Because of pressure on the sole of the foot, a layer of hard skin forms over the wart. A plantar wart may or may not be painful. It can be spread in communal showers, around swimming pools, by sharing shoes, etc.
Diagnosis
Plantar warts, can often be differentiated from helomata, corns, by close observation of skin striations. Feet, like hands, are covered in skin striae, which are more commonly called fingerprints. With plantar warts, the skin striae go around the lesion; if the lesion is not a plantar wart, the cells’ DNA is not altered and 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. Helomata tend to be painful on direct pressure rather than pressure from either side.
The difference between plantar warts and warts elsewhere on the body is that warts are generally outgrowth lesions, but on the bottom of the foot, they are pushed inward by the pressure of walking. Since the skin on the bottom of the foot tends to be thicker than elsewhere, the treatment of plantar warts is more difficult.
Treatment
No treatment in common use is 100% effective. The most comprehensive medical review found that no treatment method was more than 73% effective and using a placebo had a 27% average success rate. The American Family Physician recommends:
Podiatrists and dermatologists are considered specialists in the treatment of plantar warts, though most warts are treated by primary care physicians.
Vaccination
Although immunization is available for the HPV and strains causing cervical cancer and venereal warts, there is currently no vaccination treatment for plantar warts.
Pharmacologic Rx
As warts are contagious, precautions should be taken to avoid spreading.
Surgical
Other
Relative Effectiveness Of Treatments
A 2006 study assessed the effects of different local treatments for cutaneous, non-genital warts in healthy people.The study reviewed 60 randomized clinical trials dating up to March 2005. The main findings were:
Complications
Warts may spread, develop into clusters or fuse to become a mosaic wart. Plantar warts can be painful making it difficult to walk and run. Over-aggressive treatment may lead to scarring. Others may be infected. If a wart is being treated professionally and does not seem to improve in a reasonable period of time, the growth should be excised and biopsied.
Prevention
Promotion
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