A wart or verruca plantaris is a lesion on the skin that occurs when the skin is infiltrated by a virus. Warts can occur anywhere on the foot/ankle, but they usually occur on the bottom (plantar side) of the foot. Plantar warts are most common in children, adolescents, immune-compromised individuals, and the elderly.
What Is a Plantar Wart?
There are two types of plantar warts:
- A solitary single wart. This lesion usually increases in size and can eventually spread, forming multiple satellite warts.
- Mosaic warts or clusters. This occurs when several smaller warts are in close proximity to one another. These lesions are usually harder to treat.
What Causes Plantar Warts?
Plantar warts occur where there is direct contact with the human papilloma virus (HPV). There is usually a portal of entry/break in the skin that allows for the infiltration of the wart.
There are over 100 different types of HPV. Only a few cause lesions on the foot. Others may cause lesions in other parts of the body and mucous membranes.
Risk factors for warts include:
- Children and teenagers
- People with weak immune symptoms or those with autoimmune conditions
- Those who have had warts before
- Walking barefoot, exposure to warts in places such as gyms and locker rooms
What are the Symptoms of Warts?
The symptoms of a plantar wart may include:
- Thickened skin. Warts will have thickened skin, with skin lines that diverge away from the lesions.
- Pain. Warts may be painful especially when squeezed from the sides.
- Tiny black dots. The tiny dots represent small clotted up capillaries that contain clusters of the warts. This is why there may be some pinpoint bleeding after wart debridement.
Diagnosis & Treatment
Diagnosing warts starts with a good physical examination and history
Your physician may perform debridement of the wart/callus skin till there is pinpoint bleeding. This helps to expose the viral particles and allows for direct application of the medication
The goal of any wart treatment is to help the body’s own immune system recognize the viral particles as foerign particles. In order to do that the physician may perform:
- Salicylic acid treatment
- Cryotherapy (freeze spray)
- Cantherin acid
- Laser therapy
For those that have failed conservative therapy, your physician may elect to perform surgical therapy which includes:
- Surgical excision with cauterization
- Biopsy for accurate diagnosis
- Bleomycin sulfate injection
- Surgical excision with implantation into the muscle belly