A plantar wart is a benign growth on the soles of the feet or toes.Plantar warts are found in about 34 percent 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, conversely, severely damaged surrounding tissues can cause the appearance of neoplasms in other parts of the body.
Causes of plantar warts
Warts, 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 through 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 bathrooms, saunas, swimming pools and gyms.If the body's immunity is sufficiently strong, 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, which squeeze and rub;various foot deformities (deforming arthrosis, 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 1-2 cm and protrudes 1-3 mm above the skin.The skin color of a plantar wart usually stays the same, but can sometimes be pink or light brown.
Initially, 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 seen.The brown-black spots, which are often observed on the surface of the wart, are caused by thrombosis of the superficial 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 in such 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 considerable 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 resembles a thickened stratum corneum (hyperkeratosis) or a callus.Only a highly trained 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 and PCR diagnostic results confirm 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 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 size and smaller (flat, non-conical) shape 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 common features with palmoplantar syphilis.Syphilis are multiple in nature, have a specific ring-shaped or arched 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 into the dermis, unlike other types of tumors.For this reason, for example, electrocoagulation is not always suitable for the removal of warts.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 liquid nitrogen treatment at the site of a wart should not be injured until it heals (healing takes about a week).
Laser removal offers the best aesthetic result, as this method allows you to adjust the depth of exposure.Laser wart removal is painless and quick, and healing takes several days.
To remove a plantar wart, the radio wave method can also be used, in which the tumor is cut with a radio knife.At the same time, cauterization of the vessels occurs, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is indicated for plantar warts that reach large dimensions.The procedure is performed 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
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 bathrooms.A significant role in the prevention of 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 treatment of the feet with emollients, as well as regular pedicures.
Patients suffering from foot deformities should use orthoses, relief 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 cracks are present, 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 and immunocorrecting drugs.