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, because a plantar wart has a root that goes 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 new growths to appear in other parts of the body.
Causes of plantar warts
Condylomas, papillomas and other types of warts (plantar, common, filiform, flat) occur as a result of infection of the human body with the human papilloma virus (HPV).HPV is transmitted between people by contact (via infected cells).The most favorable environment for transmitting the virus will be 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 show any clinical manifestations.A decrease in the immune system activates the virus and the above-mentioned 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 squish and rub;various foot deformities (deforming osteoarthritis, joint arthritis, flat feet);diseases that disrupt the trophism of foot tissue (atherosclerosis, varicose veins of the lower extremities, diabetes mellitus, etc.), damage to the surface of the foot.
Manifestations of plantar warts
Often, a plantar wart has a round or oval 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.
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-like depressions are sometimes observed.Black-brown dots, which can often be seen on the surface of the nipple, are caused by thrombosis of superficial capillaries.
Plantar warts are in most cases individual in 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, which is why they are called "mosaic warts".
Plantar warts may go away on their own.On the skin of the feet 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 significant discomfort to the patient, and often sharp pain caused by pressure or friction of the nipple against the sole of the foot.
Diagnosis of plantar warts
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 dermatoscopy.To better examine the formation, the dermatologist first scrapes off the top layer of keratinized skin.In support of a neoplasm, the skin sample that is absent on the surface of the formation and the identified symptoms of petechiae ("thrombosed capillaries") speak.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 of the skin formations.However, if there is a suspicion that the wart is malignant, the patient should consult a dermato-oncologist.If a disease or deformity of the foot is detected, in that case it is necessary to consult a pediatrician.
Plantar warts are considered separately from keratoderma of the palms and soles in Reiter's syndrome.Smaller size and shape (flat, not conical) formations, petechia or so-called.the symptom of "thrombosed capillaries", as well as the absence of inflammatory changes around the keratinized layers of the epidermis, make it possible to distinguish plantar warts from keratoderma.
Plantar warts also have some common features 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 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 possible only when the plantar wart is not deeply located.In this case, electrocoagulation will ensure healing without marks.
Cryodestruction of the wart gives positive results, which directly depend on the qualifications of the specialist, because excessively deep action on the tumor can lead to scars, and too superficial can lead to the reappearance of the wart.The blister that appears after liquid nitrogen treatment on the nipple should not be injured until it heals (healing takes about a week).
Laser removal gives the best cosmetic result, because this method allows regulation of 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 excised with a radio knife, can also be used to remove a plantar wart.At the same time, blood vessels are cauterized, which prevents the virus from entering the blood from the neoplasm.
Surgical removal is suitable for plantar warts that reach large sizes.The operation is performed with an ordinary scalpel and the use of local anesthetic.There is a possibility of complications - it is the appearance of a scar.
Prevention of plantar warts
The primary prevention of plantar warts is to prevent HPV infection.It is worth paying special attention to the mandatory wearing of personal footwear in places such as showers, swimming pools and bathtubs.A significant role in the prevention of plantar warts in people suffering from foot diseases is played by proper and regular care of the skin of the feet: exfoliation and treatment of the feet with emollients, as well as regular pedicures.
Patients suffering from foot deformities should use orthoses, weight-relieving sectors and orthopedic insoles.If your feet sweat a lot, you must use deodorizing and drying products and choose shoes made of natural materials.If the skin of the feet is too dry and there are cracks on it, then in that case it is necessary to use creams that can nourish and moisturize the skin of the feet.You should also regularly take medicated foot baths.
Secondary prevention of the occurrence of plantar warts is to prescribe antiviral drugs and immunocorrectors to the patient, along with wart removal.