Plantar warts are benign growths on the soles of the feet or toes.Plantar warts are found in about 34% of non-cancerous skin growths.Dermatology deals with the diagnosis and further treatment of the neoplasm.When trying to cure warts, it is highly undesirable to use traditional methods and try to remove them yourself, because plantar warts have roots that go deep into the skin and their incomplete removal can cause secondary growth of warts, or, on the contrary, badly injured surrounding tissue 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 spread among people through contact (through infected cells).The most suitable environment for virus transmission is a warm and humid environment.Therefore, 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 failure of the immune system activates the virus and the formation above begins to appear on the skin.
The appearance and development of plantar warts is facilitated by factors such as excessive dryness or sweating (hyperhidrosis) on the skin of the feet;uncomfortable, squeezing and rubbing shoes;various foot deformities (deformative osteoarthritis, joint arthritis, flat feet);diseases that disturb the trophism of leg tissue (atherosclerosis, varicose veins on the lower leg, diabetes mellitus, etc.), damage to the surface of the leg.
Manifestations of plantar warts
Usually, plantar warts have a round or oval shape with a diameter of about 1-2 cm and protrude 1-3 mm above the skin.The skin color of plantar warts usually stays the same, but can sometimes be pink or light brown.
At first, the surface of the wart is smooth, but then the neoplasm is covered with a layer of keratin epidermis, the surface becomes rough and changes color to gray-yellow.In the middle, on the surface of the plantar wart, a crater-like depression is sometimes observed.Black-brown dots, which can often be observed on the surface of warts, are caused by surface capillary thrombosis.
Plantar warts in most cases are solitary.The formation of similar warts may indicate that the virus has reached a high level of activity.Multiple warts give the affected skin a mosaic pattern, which is why they are called "mosaic warts."
Plantar warts may go away on their own.On the skin of the feet 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 significant discomfort and often a sharp pain due to the pressure or friction of the wart on the sole of the foot.
Diagnosis of plantar warts
Plantar warts often look like a thickened stratum corneum (hyperkeratosis) or callus.Only a highly qualified dermatologist can distinguish warts from calluses and hyperkeratosis.To do this, the doctor performs dermatoscopy.To better examine the formation, the dermatologist first scrapes the top layer of keratinized skin.The skin pattern is not present on the surface of the formation and the identified symptoms of petechiae ("capillary platelets") speak in favor of a neoplasm.Positive results for HPV and PCR diagnosis confirm the fact that the patient is infected.
To determine the depth of the root of the plantar wart that has germinated, the patient is prescribed an ultrasound of the skin formation.However, if there is suspicion that the wart is malignant, the patient should consult a dermato-oncologist.If a foot disease or deformity is detected, in this case it is necessary to consult a podiatrist.
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 formation, petechiae or the so-called "thrombosed capillaries" symptom, as well as the absence of inflammatory changes around the keratin layer of the epidermis, make it possible to distinguish between plantar warts and keratoderma.
Plantar warts also have some common features with palmoplantar syphilis.Syphilis is multiple in nature, has a certain ring or arcuate arrangement, it is painless and has a positive RPR test for syphilis.
Treatment of plantar warts
Removal of plantar warts is complicated because they grow deep into 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 only possible when plantar warts are not deeply located.In this case, electrocoagulation will ensure healing without a trace.
Cryodestruction of warts gives a positive result, which directly depends on the qualifications of the specialist, because too deep an impact on the tumor can cause scarring, and too superficial an impact can lead to the reappearance of the wart.Blisters that appear after treatment with liquid nitrogen at the site of warts should not be injured until they heal (healing takes about a week).
Laser removal provides the best cosmetic results, as this method makes it possible to control the depth of exposure.Laser removal of warts is painless and quick, and healing lasts about a few days.
The radio wave method, where the tumor is cut with a radio knife, can also be used to remove plantar warts.At the same time, cauterization of vessels occurs, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is appropriate for plantar warts that reach a large size.The procedure is carried out using a common scalpel and the use of local anesthetic.There is a possibility of complications - this is the appearance of scars.
Prevention of plantar warts
The main prevention of plantar warts is to prevent HPV infection.Special attention should be paid to the mandatory wearing of personal shoes in places such as showers, swimming pools and baths.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 treating 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 need to use deodorizing and drying agents and choose shoes made from 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 a cream 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 patients, along with the removal of warts, are also prescribed antiviral drugs and immunocorrectors.