Verruca plantaris B07

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 27.02.2021

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Synonym(s)

Myrmecia; plantar warts; Plantar warts; Thorn warts

Definition
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Warts on the soles of the feet, localized infectious disease caused by human papilloma viruses (HPV), with painful growth directed into the depth (development to the depth occurs because a "normal" exophytic growth is not possible due to the constant pressure load during walking). In short, a plantar wart could be described as an "indented" vulgar wart, which becomes painfully noticeable when walking, like a thumbtack placed there.

Pathogen
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Human papillomavirus type 1,2,4,27 (57,60,63,65); see also papillomavirus, human.

Occurrence/Epidemiology
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Preferred in children < 12 years; up to 20% of 12-year-olds are affected, in 20-year-olds only 2-3%. Transmission occurs through contact with virus particles in swimming pools, community showers or gymnasiums. In moisture and heat, infected keratinocytes are released by virus carriers and virus material can then penetrate the skin of the sole of the foot.

Localization
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soles

Clinical features
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Solitary, but mostly multiple, also aggregated to 4-7 cm large, planar beds, crater-shaped, 0.2-0.5 cm large horn lesions with lip-shaped rim by raised normal epithelium. Whitish scaly, in larger beds also greyish-yellow to grey-brown surface, pain on exertion. Initial changes can be recognized by the interruption of the normal inguinal relief (see figure). Frequently, pinhead-sized bleeding spots are visible in the lesions.

Mosaic warts are warts on the sole of the foot which confluent to form flat nipple beds.

In permanently immunocompromised patients, unusually extensive, absolutely therapy-resistant wart beds can develop, so that the suspicion of an immunodeficiency can be expressed solely on the basis of the severity of the disease.

Histology
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Corresponds in principle to Verruca vulgaris. Histomorphologically the picture of an invaginated Verruca vulgaris is shown. Typical are abundant koilocytes as a sign of HPV-induced damage to the keratinocytes.

Differential diagnosis
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Therapy
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S.u. Wart

Progression/forecast
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Persistence and recurrence are to be expected.

Literature
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  1. Grussendorf-Conen EL (1992) Age-related therapeutic response of plantar warts. dermatologist 43: 458
  2. King CM et al (2014) Human papillomavirus types 2, 27, and 57 Identified in plantar verrucae from HIV-positive and HIV-negative individuals. J Am Podiatr Med Assoc 104:141-146Serour F et al (2003) Successful treatment of recalcitrant warts in pediatric patients with carbon dioxide laser. Eur J Pediatrics Surgery 13: 219-223
  3. Smith EA et al (2015) Evaluating the success of Nd: YAG laser ablation in the treatment of recalcitrant verruca plantaris and a cautionary noteabout local anaesthesia on the plantar aspect of the foot. J Eur Acad Dermatol Venereol 29:463-467
  4. Wollina U et al (2001) Treatment of common warts and actinic keratoses by Er:YAG laser. J Cutan Laser Ther 3: 63-66
  5. Zamiri M, Gupta G (2003) Plantar warts treated with an immune response modifier: a report of two cases. Clin Exp Dermatol 28(Suppl1): 45-47

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 27.02.2021