Plantar warts are benign growths on the soles of the feet or toes.Plantar warts are present in about 34% of non-cancerous skin growths.Dermatology is responsible for the diagnosis and further treatment of such tumors.When treating warts, it is extremely not advisable to use traditional methods to remove them yourself, because the roots of plantar warts penetrate deep into the skin, and incomplete removal can lead to secondary growth of the warts, or conversely, severe damage to surrounding tissues can lead to tumors in other parts of the body.
Causes of plantar warts
Genital warts, papillomas, and other types of warts (plantar warts, common warts, filamentous warts, flat warts) are caused by infection with the papilloma virus (HPV).HPV is spread from person to person through contact (through infected cells).The environment most conducive to the spread of the virus is a warm and humid environment.As a result, people often contract HPV in bathrooms, saunas, swimming pools, and gyms.If the body's immunity is strong enough, HPV can remain latent and will not show any clinical manifestations.A malfunction in the immune system activates the virus, and the above-mentioned structures begin to appear on the skin.
Factors such as excessive dryness or sweating of the foot skin (hyperhidrosis) can promote the appearance and development of plantar warts; uncomfortable, squeezing, and friction shoes; various foot deformities (deformation osteoarthritis, arthritis, flat feet); diseases that destroy the nutrition of foot tissue (atherosclerosis, varicose veins of the lower limbs, diabetes, etc.), and damage to the surface of the foot.
Symptoms of plantar warts
Usually, plantar warts are round or oval in shape, about 1-2 cm in diameter, and protrude 1-3 mm from the skin.The skin color of plantar warts usually remains the same, but sometimes it may be pink or light brown.
At first, the surface of the wart is smooth. Later, the wart is covered by layers of keratinized epidermis, and the surface becomes rough and turns gray-yellow in color.A crater-like depression sometimes appears in the center of the plantar wart's surface.Dark brown dots are often visible on the surface of warts, which are caused by capillary thrombosis on the surface.
Most often, plantar warts are single.The formation of wart-like symptoms 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.In this case, they disappear without a trace on the skin of the feet.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 significant discomfort to the patient, and often even cause severe 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 thickened cuticles (hyperkeratosis) or calluses.Only a highly qualified dermatologist can differentiate between warts, calluses and hyperkeratosis.To do this, the doctor will perform a dermoscopy.To better examine the structure, the dermatologist first scrapes off the top layer of keratinized skin.Absent skin patterns on the surface of the formation and identified symptoms of petechiae ("thrombosed capillaries") suggest neoplasia.Positive results for HPV and PCR diagnostics confirmed that the patient was infected.
To determine the depth of the root of an emerging plantar wart, the patient undergoes an ultrasonographic examination of the skin structure.However, if a malignant nature of the wart is suspected, the patient should consult a dermatologic oncologist.If a foot disease or deformity is discovered, in this case it is necessary to consult a podiatrist.
Plantar warts in Reiter's syndrome are considered separately from keratoses of the palms and soles.The small size and shape (flattened, non-conical) of the structure, petechiae or so-called "thrombotic capillary" symptoms, as well as the absence of inflammatory changes around the epidermal cornified layer, make it possible to differentiate between plantar warts and keratosis.
Plantar warts also share some characteristics with palmoplantar syphilis.Syphilis is multiple in nature, has a specific ring or arcuate arrangement, they are painless and the RPR test for syphilis is positive.
Treatment of plantar warts
Removing plantar warts is complicated because, unlike other types of tumors, it grows deep in the dermis.For this reason, for example, electrocoagulation is not always suitable for removing warts.Electrocoagulation can only be used if the plantar wart is not deeply located.In this case, electrocoagulation will ensure scarless healing.
The positive results of cryodestruction of warts directly depend on the qualifications of the specialist, since too deep an impact on the tumor can lead to scarring, and too shallow an impact can lead to the recurrence of warts.Blisters that appear after treating a wart area with liquid nitrogen should not hurt until they heal (healing takes about a week).
Laser removal provides the best cosmetic results because this method allows the depth of exposure to be adjusted.Laser wart removal is painless and fast, and healing can last about a few days.
Radio wave method (removing tumors with a radio knife) can also be used to remove plantar warts.At the same time, blood vessels are cauterized, preventing the virus from entering the bloodstream from the tumor.
Surgical excision is indicated for larger plantar warts.The surgery is performed using a regular scalpel and using local anesthetic.There is a possibility of complications - this is the appearance of scars.
Prevention of plantar warts
The primary prevention of plantar warts is to prevent HPV infection.Of particular note is the mandatory wearing of personal shoes in areas such as showers, swimming pools and bathrooms.For people with foot problems, proper and regular care of the foot skin plays an important role in preventing the formation of plantar warts: peeling the feet, treating them with emollients and getting regular pedicures.
Patients with foot deformities should use orthotics, unloading fans, and orthopedic insoles.If your feet sweat a lot, you'll want to use deodorants and dryers, and choose shoes made from natural materials.If the skin on your feet is too dry and cracked, you need to use a cream that can nourish and moisturize the skin on your feet.You should also take regular medicated foot baths.
Secondary prevention of plantar warts involves prescribing antiviral drugs and immune correctors to the patient while removing the warts.