Plantar warts are a very coarse non-malignant (not caner) skin condition found on the feet. These skin lesions are caused by various types of human papillomaviruses (Hpv). The formation of plantar warts begins when the Hpv enters cuts or cracks on the bottom of the foot. Plantar warts generally appear on areas of increased pressure such as the heel or ball of the foot. If the plantar wart is found on an area of high pressure, the wart becomes thickened. It then grows into the foot and can come to be painful with walking and running. Other characteristic of plantar warts is they ordinarily form in small clusters called satellite warts that radiate from a larger plantar wart.
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Physical Exam of Plantar Warts:
Plantar warts can be confused with skin melanomas (cancer), which can be harmful and/or life-threatening if the cancer cells spread. They may also be confused with calluses, which form due to increased pressure to the feet. The skin lesion will be examined for proximity of skin lines and color. If the skin lesion is thickened and multicolor, skin melanomas are suspected and a skin biopsy is performed to confirm the finding. In contrast to skin melanomas, plantar warts ordinarily appear uniform in color. When comparing plantar warts to calluses, plantar warts do not have skin lines and will bleed if the area is shaved down with a scalpel. Additionally, patients with plantar warts will show signs of pain if the wart is squeezed as opposed to direct pressure applied to the top. Medicine of Plantar Warts: Plantar warts can be very difficult to treat because confident treatments sway each type of human papillomaviruses differently. To add to the difficult Medicine of plantar warts, Hpv has come to be more resistant to current treatments. Fortunately, there are many options to treating plantar warts, starting from a more conservative, non-surgical care to surgical solutions of excising the skin lesion.
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First line of treatment:
The first line of Medicine of plantar warts is over-the-counter solutions, creams, or patches containing salicylic acid like Trans-Ver-Sal or Duofilm. The acid softens the thick hard skin so that a pumice stone or file can be used to rub off the plantar wart. The advantages of using an over-the-counter goods are its low cost and minimal discomfort. The disadvantage of using the products is the duration of the Medicine and its dangers to diabetics and/or patients with circulatory problems. The whole course of Medicine ordinarily requires a diligent and quarterly application for a minimum of 3 months.
Plantar Warts and Its treatment
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Second line of treatment:
A second line of Medicine is cryotherapy. The wart is freezing with chemicals until a 1-2 mm white halo surrounds the plantar wart. This course is performed at the podiatrist office every 2-3 weeks.
The next method of Medicine in the second line is Cantharone compounds. Using this method, the podiatrist will first shave all of the excess callus tissue from the top of the wart. Next the Cantharone combination is applied, allowed to dry and then covered with a band-aid. When possible, pads will be applied colse to the treated area to off load pressure. Usually, there is no pain when the combination is applied. Within 3 to 7 hours the combination works into the skin and will begin to burn. After about 24 to 48 hours, a blister will form. As the blister forms this area can come to be quite painful. The blister is ordinarily deeper than a coarse water blister and may appear white, yellow or dark in color. When the blister is forming, the patient is encouraged to soak the area. Once the blister is formed the patient should try to puncture the blister and publish the fluid. During the first few days, and maybe as long as a week, the treated area can be painful and the patient should continue using a pad to keep pressure off of the blister.
Another second line Medicine is a prescribe cream, such as Aldara, containing the active ingredient, imiquimod or Carac cream containing the active ingredient, fluorouracil. The imiquimod in the Carac cream activates the body's immune cells that fight bacteria, viruses and destroy the Hpv cells. The precaution to Aldara cream is that pregnant women and children under the year of 12 years old should not use it. The duration of Aldara cream Medicine is a maximum of 16 weeks. Creams with fluorouracil inhibit viral increase and stops the Hpv in plantar warts from growing. The duration of this Medicine is about 2 weeks. For both topical treatments, irritation, itchiness, and blush to the skin can occur.
The last therapy in the second level of wart Medicine is injections of Candida antigen into the lesion. Approximately 0.3cc of the antigen is injected directly into the wart. This works by initiating a local allergic response. When the patient's body reacts to the allergen, antibodies are sent to the area and will try to destroy the Candida particles. These same immune cells will also assault the wart tissue. This course is done in the doctor's office every other week and could take up to seven treatments. The down side to this Medicine is the patient may occasionally feel flu like symptoms the day after the procedure.
Third line of treatment:
The third line of Medicine is the surgical discharge of warts. This course is performed in the podiatrist office and requires local anesthetic injections to numb the foot.
A curette, a small spoon-like instrument, it is used to scoop out the infected tissues and scrape out the viral cells that are embedded in the skin. Finally, phenol (a marvelous form of alcohol that burns tissue and stops bleeding) may be used to kill the viral particles from the plantar wart and decrease bleeding from the procedure.
The area is then covered with gauze and bandages. After this course is done the patient is required to decrease pressure on the foot to alleviate pain and allow the area is heal. After the surgical procedure, the patient will need to return to the podiatrist office in order to corollary the effectiveness of the course and to value the medical enlarge of the wound. The disadvantage to this Medicine is there is a possibility a painful scar may form at the site of the surgery.
Prevention:
1. Avoid walking barefooted in public showers or swimming pools
2. Avoid sharing shoes and socks
Plantar Warts and Its treatment
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