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 yourself, since a plantar wart has a root that goes deep into the skin, and its incomplete removal can lead to the secondary growth of the wart, or, on the contrary, the surrounding tissues that are severely damaged 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 through contact (via infected cells).The most favorable environment for the transmission of the virus will be a warm and humid environment.Therefore, people often get 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 manifestation.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 that squeeze and rub;various deformities of the feet (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.), damage to the foot surface.
Manifestations of a plantar wart
Often, a plantar wart has a round or oval shape with a diameter of about 1-2 cm and extends 1-3 mm above the skin.The skin color of plantar warts usually remains the same, but sometimes it can be pink or light brown.
At first, the surface of the wart is smooth, but later the neoplasia is covered with layers of keratinized epidermis, the surface becomes rough and changes color from yellow to gray.In the center, on the surface of the plantar wart, crater-like depressions are sometimes observed.Black to brown dots, which can often be seen on the surface of the wart, are caused by thrombosis of superficial capillaries.
Plantar warts in most cases are of a single 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, hence the name "mosaic warts".
Plantar warts may disappear on their own.On the skin of the leg in such conditions they disappear without leaving a trace.However, since warts often hurt, 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 sharp pain caused by the pressure or friction of the wart on the sole.
Diagnosis of plantar warts
A plantar wart often looks like a thickened layer of corneum (hyperkeratosis) or a callus.Only a highly qualified dermatologist can distinguish a wart from a callus and hyperkeratosis.To do this, the doctor performs a dermatoscopy.To better examine the formation, the dermatologist first scrapes the top layer of keratinized skin.The skin pattern that is absent on the surface of the formation and the identified symptoms of petechiae (“thrombosed capillaries”) speak in favor of a neoplasia.Positive results for HPV diagnosis and PCR confirm the fact that the patient is infected.
To determine the depth of the root of a growing plantar wart, the patient is prescribed an ultrasound of the skin formations.However, if the wart is suspected to be malignant, 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 pediatrician.
Plantar warts are 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 "thrombosed capillaries" symptom, as well as the absence of inflammatory changes around the keratinized layers of the epidermis, make it possible to distinguish between plantar warts and keratoderma.
Plantar warts also have some features in common with palmoplantar syphilides.Syphilides are multiple in nature, have a specific ring or arc arrangement, are painless and have a positive RPR test for syphilis.
Treatment of plantar warts
Plantar wart removal is complicated because it grows deep in 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 possible only when the plantar wart is not deeply located.In this case, electrocoagulation will provide healing without a trace.
Cryodestruction of the wart gives positive results, which directly depend on the qualifications of the specialist, because a too deep effect on the tumor can lead to scarring, and a very superficial effect can lead to the reappearance of the wart.A blister that appears after liquid nitrogen treatment at the site of the wart should not be injured until it heals (healing takes about a week).
Laser removal gives the best cosmetic result, as this method makes it possible to adjust the depth of exposure.Laser wart removal is painless and quick, and recovery takes about a few days.
The radio wave method, in which the tumor is cut 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 appropriate for plantar warts that reach large sizes.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 the prevention of HPV infection.It is worth paying special attention to the mandatory wearing of personal shoes in places such as showers, swimming pools and bathrooms.An important 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 treatment of 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 should use deodorizing and drying agents and choose shoes made from natural materials.If the skin of the feet is very 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.
The secondary prevention of the appearance of plantar warts is that, along with the removal of the wart, antiviral and immunocorrective drugs are also prescribed to the patient.