Plantar Verruca (Warts)

Verrucase Vulgaris, also known as the common wart, are skin infections caused by the human papilloavirus (HPV). There are over 100 different strains of the virus that occur all over the body. They are spread by physical contact. 

ANATOMY 

Plantar warts infect the epidermis, most superficial layer of skin, specifically keratinocyctes. 

EXAM AND DIAGNOSIS

Warts are diagnosed clinically by the following observations: 

• Absence of skin lines in the lesion. 
• Thickening of overlying skin, often mistaken for a callus. 
• Presence of multiple dots or a single black dot caused by small capillaries that have developed to nourish the infected tissue. 
• Tenderness with lateral pressure (pinching it). 

They can present as either single lesions (solitary) or in clusters of lesions (mosaic). 

TREATMENT

There are many different treatment options available ranging from oral medications, topical medications, laser therapy, cryotherapy (freezing), and surgical removal. While approx 65% of warts resolve without intervention after 2 years many patients want faster relief. This is an area that is in need of more research to figure out which of the long list of treatments is most effective. Treatments that are currently used include the following: 

Topical Medications

• Salicylic Acid - can be purchased over the counter and an effective first line treatment. 
• Imiquimod 
• Cantharone
• 5-flourouracil 5% Cream

Intralesional Tharpy (injections)

• bleomycin

Oral Medications

• cimetidine

Other Treatments

• Duct Tape Occlusion - shown not to work
• Cryotherapy
• Laser Therapy

PREVENTION

Because HPV is spread by contact prevention consists of protecting your feet. These suggestions include: 

• Avoid walking barefoot through public places. 
• Clean feet daily with soap and water.