Plantar Warts

What are plantar warts?

The word ‘plantar’ means ‘undersurface’, hence, the warts that grow on the underneath surface of the foot is scientifically termed as “plantar warts”.

Plantar wart is a solid, rough enlargement of the skin developed in the heel of the feet or other associated areas where the pressure is generated in excess during walking. Callus or hard skinned layer is formed at the inner side of the warts or just beneath the upper skin layer of the feet due to the excessive pressure or friction. Tenderness is a common symptom of this type of warts and are frequent in children. ^(1,2)

Plantar Warts Causes

Warts are the outcome of viral infection. The virus that is involved in developing the warts is Human Papilloma Virus (HPV). HPV has more than 100 types of strain and 1, 2, 4, 27 and 57 are the different strains that are responsible to cause of plantar warts.

The virus enters through the skin to skin contact and often penetrates in the blood stream via the damage in the skin surface. Warts are contagious infection and the infection favorably transmit in the moist places, like swimming pools or locker room floors, shower and gym, in these areas the chances of existence of “skin residue” is maximum and moisture helps to keep the virus alive.

Warts can affected in any skin types and in different body parts. ‘Planter warts’ are the specific types of warts which develop on the sole of the foot. For prevention, covered protective foot wear can be useful.

Children are more susceptible towards the plantar warts, as their immune system is in developing stage, which cannot fully defend body against different infectious agent. But adults with immunosuppressant diseases or therapies are also susceptible towards plantar warts. ^(2,4)

Specificity of plantar warts

It is obvious that somebody can mistake between corns or calluses with warts and vice versa. Sometimes it is also possible that some serious skin problem like certain types of cancerous or malignant tissue growth on the foot are mistakenly identified as plantar warts. It is always advisable that any bumpy skin development in the foot should be checked by specialized doctor to avoid any incorrect diagnosis. Some specification of plantar warts are:

• Although corns, calluses and plantar warts are hard and flat surfaced, but has a well distinct marginal border.
• In contrast with planter warts, other warts develop on the fingers, toes or hands, are usually more elevated.
• The usually plantar warts are in gray color, but also they can different in color.
• A distinct black pinpointed spot in plantar warts represents clotted blood vessels, which supply the blood to the warts. This is a special feature of warts. A pinpoint bleeding is common during physician trimmed the warts.
• The planer warts become worsen and spread to larger area (more than an inch) and even affect in other foot. or bunch of warts group together and formed clusters.
• Planter warts is a contagious disease condition and spread by touching or contacting with other individuals and also infect other body parts.
• Planter warts are often painful.
• Athletes should be careful about these types of warts and untreated condition can affect the walking and other types of leg movement and ultimately cause pain in foot, legs and back. ⁽⁴⁾

Plantar Warts Risk Factors

Following are the risk factors associated with development of plantar warts:

In most of the cases, it is found that children and teenagers are more susceptible towards the infection, though any aged people can develop plantar warts, who have weak immune systems.

• Individuals already having previous history for development of plantar warts.
• Individuals who walk barefoot where exposure of wart-producing HPV is widespread like municipal washrooms.

Diagnosis

The commonly followed steps to diagnose the planter warts:

• Lesion examination
• The upper layer of the skin is removed and identify the black spot, which is the hallmark of the planter warts.
• For biopsy, shave small section of tissues from the warts and through histological examination is conducted in the clinical laboratory checking for examination. ⁽³⁾

Plantar Warts Removal/treatment/how to get rid of:

The planter warts can be treated, removed by home treatment method or physician can also prescribe some treatment process for treating the planter warts.

Home remedies

Apply duct tape on the warts and keep that piece for 6 days. Then take out the tape piece and moist the warts skin with water, when the upper layer of the skin become soften, then gently rub the skin with a pumice stone for removing the dead skin. This process must be repeated until the whole warts become cure.

Different wart removing OTC products are available in the market and half of the cases are resolved by using these products. These products helps to peel out the wart’s skin layer, as they help to dry the skin layer. Usually these products contain salicylic acids.

Doctors’s therapy

• Upton’s paste: This is a paste made with salicylic acid and trichloroacetic acid. In addition, for making a paste glycerin is added. This paste helps to cure the warts.
• 5- flurouracil is a chemotherapeutic agent, that can also be used as a topical application for treating the planter warts.
• Laser rays are also used to treat warts.
• Liquid nitrogen is used for freezing the skin of the warts and then skin become blackish due to too much cold and then skin tissue necrosis is occurred and gradually dead skin is removed.
• Immune booster injections may doctors prescribed for weaken immune system. ^{(2, 3)}

Prevention

• Do not walk in barefoot, in the public bathrooms or where the infectious agent can survive easily
• Wear protective foot wear in the public places.
• Avoid skin to skin contact to restrict the transmission of the infection.
• Regular visual examination of the feet for child should be conducted by parents to early identification.
• Care should be taken for feet, which include maintenance of cleanliness and dryness.
• Use cotton clothing socks to avoid moist feet  due to sweating, as cotton cloth is a good absorbent.
• Any changes in the skin of the feet need to carefully attend. ⁽⁴⁾

Prognosis

1. The chance of reemission of planter warts is 60% and this can be controlled by boosting immune system.
2. The risk of planter warts getting malignant is low, though some strains of HPV cause cancerous development.
3. Excisional surgery do not provide favorable result to treat planter warts, as the scar may cause problem in walking. ⁽³⁾

Pictures

References:

1. Debra Jaliman (2015); Plantar Warts and Palmer Warts; Retrieve from: http://www.webmd.com/skin-problems-and-treatments/guide/plantar-warts-palmer-warts
2. Plantar warts (2014); mayo Clinic; Retrieve from: http://www.mayoclinic.org/diseases-conditions/plantar-warts/basics/definition/con-20025706
3. Gary W. Cole (2015); Plantar Warts; Retrieve from: http://www.emedicinehealth.com/plantar_warts/article_em.htm
4. Stephen M. Pribut (2016); Plantar Warts; Retrieve from: http://www.drpribut.com/sports/warts.htm
5. http://www.warts.com.au/warts/wp-content/gallery/plantar-wart-treatment-case-2/plantar-wart-treatment-c2d.jpg
6. www.capitaldistrictpodiatry.com/images/182366762_PlantarWart.jpg
7. http://www.topnotchwoodworking.co/foots-plantar-wart
8. www.drugs.com/health-guide/images/205899.jpg