plantar wart

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wart

 [wort]
an epidermal tumor of viral origin; the term is also applied loosely to any of various benign epidermal proliferations of nonviral origin. Called also verruca. Warts are generally more common among children and young adults than among older persons. Most are less than 0.6 cm (a quarter of an inch) in diameter; they may be flat or raised and dry or moist. Usually they have a rough and pitted surface, either flesh-colored or darker than the surrounding skin. They usually develop on the fingers and hands, but may also occur on the elbows, face, scalp, or other areas. When on especially vulnerable parts of the body, such as the knee or elbow, they are subject to irritation and may become quite tender. Two specific types are plantar warts and venereal warts.



A wart develops between 1 and 8 months after the virus becomes lodged in the skin. The virus is often spread by scratching, rubbing, and slight razor cuts. In more than half the cases, warts disappear without treatment, but some remain for years.
Treatment. Many popular “cures” for warts have been suggested, but are generally useless. Furthermore, self-treatment by cutting, scraping, or using acids or patent medicines may cause bacterial infection, scarring, and other harm without eliminating the warts. A troublesome wart should be removed only by a health care provider, who may use acids, electrodesiccation, or freezing with liquid nitrogen. Warts are notoriously stubborn. Often the virus remains in the skin, and the wart grows again.
plantar wart a viral epidermal tumor on the sole of the foot, sometimes the result of going barefoot; unlike other warts, this type is usually sensitive to pressure and may be painful during walking. Called also verruca plantaris.
venereal w's condylomata acuminata.

plan·tar wart

Avoid the incorrect expression planter's wart.
An often painful wart on the sole, usually caused by human papillomavirus type 1.
Synonym(s): verruca plantaris

plantar wart

a painful verrucous lesion on the sole of the foot, primarily at points of pressure, such as over the metatarsal heads and the heel. Caused by the common wart virus, it appears as a soft central core and is surrounded by a firm hyperkeratotic ring resembling a callus. Multiple tiny black spots on the surface represent bits of coagulated blood. It is distinguished from a callus in that skin markings are interrupted by a plantar wart. Treatment methods include excision, electrodesiccation, cryotherapy, laser treatment, topical acids, and use of cantharidin. See also mosaic wart.
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Plantar wart

plantar wart

Verruca pedis Podiatry A virally-induced bump on the bottom of the foot, linked to the immune system, which either responds to minimal therapy or not. See Abracadabra therapy, Podophyllin.

plan·tar wart

(plan'tahr wōrt)
An often painful wart on the sole; usually caused by human papillomavirus type 1.
Synonym(s): verruca plantaris.
Enlarge picture
PLANTAR WART

plantar wart

A wart on a pressure-bearing area, esp. the sole of the foot. Synonym: verruca plantaris
See: illustration
See also: wart

plantar wart

An ordinary wart (verruca) occurring on the sole of the foot and forced into the skin by pressure from the weight of the body.

plantar verruca

; plantar wart infection of plantar skin with human papillomavirus (see verruca; virus, human papillomavirus; Table 1)
Table 1: Factors that should be considered in the use of chemical cauterizing agents to destroy verrucae
FactorComment
Lesion siteSuperficial lesion, non-weight-bearing skin - use liquid caustics
20% salicylic acid in collodion
Trichloroacetic acid, saturated solution (+75% sliver nitrate)
Deeper lesion, weight-bearing skin, good fibrofatty padding - either liquid or solid caustics
Monochloroacetic acid, saturated solution
40-70% salicylic acid ointment
Number and size of lesionsLarge lesions: ointment-based caustics
40-70% salicylic acid ointment Smaller and satellite lesions: caustic solutions
Alternating layers of trichloroacetic acid, saturated solution and 75% silver nitrate
Skin textureSweaty or hyperhidrotic skin
Padding cannot be retained in situ
Fair skin or atopic individuals; atrophic or dry skin
Tend to overreact/undergo tissue breakdown, to applied caustics
CirculationReduced arterial supply (diabetes, atherosclerosis)
Caustics may cause ulceration or predispose to infection as healing response is depressed (use astringents or mild keratolytics)
Impaired venous or lymphatic drainage (oedematous tissues)
Avoid strong caustics (use astringent agents or mild keratolytics)
NeuropathyImpaired pain awareness (as in diabetic neuropathy)
Do not use caustics (use astringents or mild keratolytics)
AvailabilityStrong acids should not be used unless both practitioner and patient are available for emergency appointments
Caustics may not be treatment of choice if patient cannot return weekly for ongoing treatments (consider a 'one-off' treatment, e.g. cryotherapy)
Opt for self-applied milder, topical ongoing treatments, if in patient's best interests
AgeStrong caustics should be avoided in young patients with a low pain threshold
Caustics that require padding to be retained in situ between treatments may be contraindicated in patients who cannot keep foot dry (e.g. swimmers)
Previous treatmentsIt is pointless continuing with a treatment that has already proved to be ineffective, or has caused an adverse reaction
Single treatmentsVerrucae pedis do not often respond to a single treatment, but methods include:
• Cryotherapy (application of liquid nitrogen, optimally every 3 weeks; ice ball must extend beyond lesion edge; contraindicated in patients with peripheral vascular disease)
• Electrosurgery (peripheral tissues must also be removed in order to clear all virally infected cells; requires local anaesthesia; contraindicated in patients with peripheral vascular disease or those with an indwelling pacemaker)
Alternative treatmentsAlternative treatments may be indicated for cases that have not responded to other forms of treatment: many of these therapies have not been tested by formal research
Thuja tincture: painted on lesion once or twice a day
Kalanchoe leaves: fleshy leaves split open and fleshy pulp left in situ on lesion; changed every 24-48 hours
Tea tree oil: painted on lesion daily, and covered
Banana skin: small piece of banana skin cut to size of lesion and strapped in place, pith side against lesion; changed every 24-48 hours