Plantar warts : a persistently perplexing problem

  • Published 2014


Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57 (see: “HPV vaccine”, Page 44).1 There is limited high-quality epidemiological data on the prevalence of plantar warts. However, they generally occur with the greatest frequency in children and adolescents.1 Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma.2, 3, 4 Diagnosis is based on clinical appearance Plantar warts can be confused with corns or calluses. The use of a hand-held dermatoscope can assist in diagnosis for practitioners trained in its use. Warts are characterised by hyperkeratosis or thickening of the skin, and are often found on pressure points. Small dots or lines are usually visible inside the lesion, which represent broken capillaries and can range from red to brown in colour.5 They are more clearly shown by dermatoscopy, where red/purple dots or clods (blood vessels) are surrounded by white circles or lobules (keratin). The blood vessels may become more obvious if the outer layers of hyperkeratotic tissue are trimmed off. In contrast, corns exhibit a translucent core (concentric fine white rings on dermatoscopy), while calluses show a generalised opacity across the lesion (structureless on dermatoscopy).5 Multiple adjacent verrucae may form mosaic warts.

Cite this paper

@inproceedings{2014PlantarW, title={Plantar warts : a persistently perplexing problem}, author={}, year={2014} }