A plantar wart is a benign growth on the soles of the feet 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 folk 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 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, threadlike, flat) are formed as a result of infection of the human body with the papilloma virus (HPV).HPV is spread between people through contact (via infected cells).The most favorable environment for transmission of the virus will be 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 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 dryness or excessive sweating (hyperhidrosis) of the skin of the feet;uncomfortable shoes, squeezing and rubbing;various foot deformities (deforming osteoarthritis, joint arthritis, flat feet);diseases that disrupt the trophism of the tissues of the foot (atherosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), lesions of the surface of the foot.
Manifestations of a plantar wart
Often, a plantar wart has a round or oval shape with a diameter of approximately 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 gray-yellow.In the center, on the surface of the plantar wart, crater-shaped depressions are sometimes noted.The black-brown dots, often observed on the surface of the wart, are caused by thrombosis of the superficial capillaries.
Plantar warts are in most cases unique in nature.The formation of similar warts may indicate that the virus has reached high activity.Many 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 significant 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 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 dermatoscopy.In order to better examine the formation, the dermatologist first scrapes the upper 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 of HPV and PCR diagnostics confirm the fact that the patient is infected.
In order to determine the depth of the root of a germinating plantar wart, the patient is prescribed an ultrasound scan of the skin formations.However, if it is suspected that the wart is 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.
The plantar wart is considered separately from keratoderma of the palms and soles in Reiter's 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 a plantar wart from keratoderma.
Plantar warts also have characteristics in common with palmoplantar syphilids.Syphilids are multiple in nature, have a specific ring or arcuate arrangement, are painless and have a positive RPR test for syphilis.
Treatment of plantar warts
Removing a plantar wart is complicated because it penetrates deep into the dermis, unlike other types of tumors.It is for this reason, for example, that electrocoagulation is not always suitable for the removal of warts.The use of electrocoagulation is only possible when the plantar wart is not deeply located.In this case, electrocoagulation will ensure traceless healing.
Cryodestruction of a wart gives positive results, which directly depend on the qualifications of the specialist, since too deep an 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 treatment with liquid nitrogen at the site of a wart should not be injured until it heals (healing takes about a week).
Laser removal gives the best cosmetic result, since this method allows you to regulate the depth of exposure.Laser wart removal is painless and quick, and healing lasts 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, cauterization of the vessels occurs, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is suitable for plantar warts that reach large sizes.The procedure is carried out using a regular scalpel and local anesthetic.There is a possibility of complications - this is the appearance of a scar.
Prevention of plantar warts
Primary prevention of plantar warts involves preventing HPV infection.Particular attention should be paid to the mandatory wearing of personal shoes in places such as showers, swimming pools and baths.Proper and regular care of the skin of the feet plays an important role in preventing the formation of plantar warts in people suffering from foot diseases: peeling and treatment of the feet with emollients, as well as regular pedicures.
Patients suffering from foot deformities should use orthotics, 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 too dry and has cracks, then 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 appearance of plantar warts consists in the fact that the patient, along with the removal of the wart, is also prescribed antiviral drugs and immunocorrectors.