Plantar warts

What are they?

Plantar warts are small calluses of the skin. They are caused by a virus called papilloma virus (human papilloma HPV) that allows epithelial cells to grow faster than others.

They are usually harmless but very contagious. Children, and especially adolescents, are more susceptible to warts than adults. There are people who have acquired immunity and do not become infected.

How do they appear?

Warts can appear anywhere on the feet. They can be single or grow in groups and are called mosaic warts.

It is not known exactly how warts spread. There is general acceptance that contagion always occurs through skin lesions caused by micro-traumas, which constitute the entry point and settlement of the viral agent. The greatest contagion usually occurs in places where there is a crowd of people and as long as the right conditions of temperature and humidity exist. Therefore, gymnasiums, swimming pool or toilet floors, the edge of swimming pools, showers, the humid sand on beaches, in short, humid places where the foot is bare, are clear candidates for catching the virus. papilloma virus.

Another source is direct infection by infiltration of the virus into the skin, it can be caused by direct contact with highly contaminated instruments (pumice stone, rasp, scalpel, etc.).

Other times self-contagion occurs, spreading to other areas of the body or to the surrounding tissue (mosaic).

From the moment of inoculation of the human papillomavirus into the epidermis, it can take from several months to two years for the wart to grow and be visible.

Clinical manifestations

These are generally asymptomatic lesions, although depending on the location they can cause discomfort, and some people feel as if they have a stone in their shoe when they walk. It is not exceptional for warts to cause itching or bleeding, and they can interrupt the patient's normal activity due to pain.

Most plantar warts do not protrude from the surface of the skin like common warts do because the pressure from walking crushes them and pushes them into the skin. They tend to be hard and flat, with a rough surface, with well-defined limits and can be easily recognized by the tiny black or brown dots that can be observed on the plantar surface.

A simple way to diagnose plantar warts is to pinch the sides of the suspicious area and if it is painful, we are dealing with a plantar wart, unlike helomas, which is usually painful on direct pressure on the callus.

Direct observation of the skin will also give us the differential diagnosis between callus and wart. Everyone knows that the skin of the hands and feet are covered with stretch marks (fingerprints), and these disappear if it is a wart, but not in cases of helomas.

Diagnosis

The basic lesion of plantar warts is a skin-colored papule, yellow or brown, hyperkeratotic and that interrupts the normal lines of the skin, the dermatoglyphs. When the warts resolve, the dermatoglyphs return to normal. After delamination of the callus with a scalpel blade, we see thrombosed capillaries in the form of black dots, a finding that reaffirms the diagnosis.

Prevention

• Avoid walking barefoot in public areas such as showers, communal changing rooms.
• Keep feet dry and clean
• Periodically check children's feet
• Change shoes and socks daily. Avoid sharing shoes and socks.
• Avoid all contact with warts, for this try not to handle yours or other people's in order to avoid direct contagion.
• Keep track of the changes your skin experiences (abnormal growths, change in color...)

self treatment

We must avoid self-treatment, since the vast majority of the time what we do is worsen the situation and infect ourselves more.

Indeed, it is not advisable to use the over-the-counter preparations that pharmacies dispense. These contain chemicals, such as acids that destroy all types of skin cells.

Therefore, if you suspect a wart, you should always consult an expert to first diagnose whether it is a wart and carry out the correct treatment in order to destroy the abnormal cells of the warts, without destroying the tissue. healthy surrounding

!Please!! If you are diabetic or suffer from circulatory disorders, you should avoid self-treatment due to the great danger that this entails.

Treatment

The treatment modalities available to us are very broad, and there is no 100% effective treatment. The difficulty lies in choosing the appropriate removal technique, which varies depending on a series of factors such as: the age of the patient, location and extension of the warts, duration of the process, clinical type of warts, immune status of the patient, intolerance to cold or allergies to medications, the correct application of treatment for the patient and its supervision by the specialist.

In Podomedic CentersWe have the following treatments available individually or in combination to combat warts:

Homeopathy

Homeopathy is a therapeutic method that in some patients is effective. It has the advantage that it does not cause pain and ensures the disappearance of the lesions without leaving a scar. It has the disadvantage of the long duration of the treatment.

It can be used as a sole treatment or as an adjuvant to other treatments.

Cryotherapy

It is an easy technique to perform and postoperative care of the injury is simple.

The most commonly used cryogen is liquid nitrogen at a temperature of -196º C. The effect on wart healing is through the necrotic destruction of keratinocytes infected by papillomavirus. Through this technique, an immune response to the virus is stimulated.

It produces a freezer burn (liquid nitrogen), forming a painful local blister, which subsequently becomes necrotic and falls off, the entire wart disappearing, without leaving scars if it has been used well.

Histofreezer® or its equivalents which are now available in pharmacies, only freeze tissue at -70ºC and the freezing is not as rapid as liquid nitrogen.

Caustics and acids

Salicylic acid is a first-line treatment. It is a keratolytic therapy whose mechanism of action consists of slowly destroying the epidermis infected by the virus.

These preparations are more effective if used under occlusion.

Nitric acid

This product can be used after careful delamination of the wart. Its treatment consists of painting its roots with said acid.

Intralesional injection of Bleomycin

Bleomycin, an antibiotic derived from the Streptomyces verticillus strain, is reserved for stubborn warts that have not responded to other treatments. It inhibits DNA and protein synthesis, triggering cell death.

surgical resection

It is the last option when all other methods have failed