Warts are caused by a virus which invades the skin through small or invisible cuts and abrasions.
The name of the virus that causes warts to form on the skin is the Human Papilloma virus. Warts can appear anywhere on the skin. Only those on the sole of the foot are properly called plantar warts. Warts are usually quite harmless, even though they may be painful. They are often mistaken for corns or calluses, which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.
Plantars warts tend to be hard and flat, with a rough surface and well-defined boundaries. Warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown, but the color may vary. They have a center that appears as one or more pinpoints of black. Unfortunately warts can be very resistant to treatment and have a tendency to reoccur.
The selection of treatment depends on the type of wart present, its location and size, and the age of the patient. In children, the simplest treatments are recommended. In more resistant lesions in older patients, the treatment may need to be more aggressive. A common and effective treatment product used is Cantharidin. This is a strong vesicant extracted from the tropical green blister beetle. When applied to the wart, this acid forms a local epidermal tissue reaction that is intense and produces a blister formation. Cantharidin is a very effective treatment for resistant warts.
Surgical removal of warts is a treatment for severe resistant warts. Electrodesiccation with curettage is one method. The electrodesiccation technique involves the use of a Hyfrecator unit with a needle-tip applicator on a hand-held instrument. The wart is anesthetized with a local anesthetic agent and the surrounding area is prepped. Surgical removal of the wart in the superficial layer of the skin is conducted, followed by electrodesiccation. This is an effective and consistent method of removing lower extremity warts documented in the literature.
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