A plantar wart is a benign growth on the foot or toes.Plantar warts occur 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, because the 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, badly 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, filamentous, flat) are formed as a result of infection of the human body with the human 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.Because of this, people often get infected with HPV in bathrooms, saunas, swimming pools and gyms.If the body's immunity is strong enough, then HPV can remain latent and not give any clinical manifestations.The collapse 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, pressing and rubbing shoes;various foot deformities (deforming osteoarthritis, joint arthritis, flat feet);diseases that disrupt the trophism of the tissues of the legs (atherosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), damage to the surface of the legs.
Manifestations of plantar wart
Often, a plantar wart is round or oval in 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 sometimes it can 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 its color to gray-yellow.In the center, on the surface of the plantar wart, cratered indentations are sometimes noticed.The black-brown dots that can often be seen on the surface of the wart are caused by thrombosis of superficial capillaries.
Plantar warts in most cases are solitary in nature.The formation of such warts may mean that the virus has reached high activity.The multiple warts give the affected area of skin a mosaic pattern, which is why they are called "mosaic warts".
Plantar warts can go away on their own.On the skin of the legs, under 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 looks like a thickened stratum corneum (hyperkeratosis) or callus.Only a highly qualified dermatologist can distinguish a wart from calluses and hyperkeratosis.To do this, the doctor performs a dermatoscopy.To get a better look at the formation, the dermatologist first scrapes off the topmost layer of keratinized skin.The absence of a skin pattern on the surface of the formation and the identified symptoms of petechiae ("thrombus capillaries") speak in favor of the neoplasm.Positive results for HPV and PCR diagnostics confirm the fact that the patient is infected.
To determine the depth of the root of a germinated plantar wart, the patient is prescribed an ultrasound of skin formations.However, if there is any doubt that the wart is of a malignant nature, the patient should consult a dermato-oncologist.If a disease or deformity of the foot is detected, in this case a consultation with an orthopedist is necessary.
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 the formations, petechiae or the so-called symptom of "thrombus capillaries", as well as the absence of inflammatory changes around the keratinized layers of the epidermis, allow to distinguish the plantar wart from keratoderma.
Plantar warts also share some characteristics with palmoplantar syphilides.Syphilides are multiple in nature, have a specific annular or arcuate pattern, are painless, and have a positive RPR test for syphilis.
Treatment of plantar warts
Removing a plantar wart is complicated because it grows deep in the dermis, unlike other types of tumors.For example, for this reason, electrocoagulation is not always suitable for removing warts.The use of electrocoagulation is possible only when the plantar wart is not located deep.In this case, electrocoagulation will provide a traceless healing.
Cryodestruction of a wart gives positive results, which directly depend on the qualification of the specialist, because too deep an effect on the tumor can lead to the formation of scars, 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 the wart should not be injured until it heals (healing takes about a week).
Laser removal gives the best cosmetic result, as this method allows adjusting the depth of exposure.Laser wart removal is painless and quick, and healing takes about a few 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 appropriate for plantar warts that reach large sizes.The procedure is performed using a simple scalpel and local anesthesia.There is a possibility of complications - this is the appearance of a scar.
Prevention of plantar warts
The main 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, pools and bathrooms.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 treatment of the feet with emollients, as well as regular pedicures.
Patients with foot deformities should use orthoses, unloading sectors and orthopedic insoles.If your feet sweat a lot, you should use deodorants and drying agents and choose shoes made of natural materials.If the skin of the feet is too 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 regularly take medicinal foot baths.
The secondary prevention of the appearance of plantar warts is that the patient, together with the removal of the wart, is also prescribed antiviral drugs and immunocorrectors.