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Woah! What's that on my foot?

Part 1

There are many soft tissue lesions that could be found in the foot. Lesions such as calluses secondary to pressure, porokeratoses, which are plugged up sweat glands, and plantar warts are usually the most common sores found on the foot. 

Verruca plantaris, or plantar warts, are lesions which are most commonly found at the heels and the balls of the feet. Many times these warts are covered by a thick layer of skin, calluses, that occur due to the constant pressure placed from movement. 
"Those with a weakened immune system are more susceptible to having warts"
Warts occur because of a virus called  human papillomavirus (HPV), which enters the body through a small cut, a break, or a weak spot in the tissue of the feet. Warts are non-cancerous lesions which cause no bodily harm, but can be very uncomfortable and create pain for the patient when putting pressure on the foot.
The HPV virus can be found in many public areas and spread from person to person. Warts can be transferred with direct or even indirect contact. An indirect transfer of the virus happens most commonly in public establishments, such as gyms; transferred from one person to another because of hygiene habits (e.g., not wearing protective shoes in the shower). Another common place in which warts are transmitted between people is in schools among young children. Many kids with a wart on their hands or feet will come in contact with other kids and spread the virus. Unfortunately, while having good hygiene is key to prevention, this is a hard virus to be completely void of. A person’s risk of getting a wart varies with how susceptible their immune system is to fighting off the virus. Those with a weakened immune system are more susceptible to having warts than others. 

Although similar to other common lesions on the foot, there are some distinct differences that confirm the presence of warts. Warts can be found, but are not restricted to, weight bearing areas of the foot. Comparing a wart to a normal callus, you will see a break in your skin line for the wart, where as in a  callus the skin line continues across the lesion. Also, in warts, you will usually see black dots appear, which are small constricted blood vessels, commonly referred to as “punctate bleeding.” Lastly, warts will usually cause pain if you squeeze the sides of the lesion, where as in a callus you will have pain with direct pressure to the lesion.

Treatment for warts is a topic that is widely discussed with many different treatments being debated. Folklore recommends that people cover the wart with duct tape for a period of time, and then debrided down is a way to treat the lesion. This doesn’t have much science behind it, however. There are many over the counter remedies that are sold by pharmacies, but they also have been proven to work only 50% of the time. It is always a good suggestion to see your doctor for evaluation and treatment. Doctors can confirm exactly what the lesion is, and then they can treat it in the best manner to remove it. If the lesion persists for a long period of time, it may have to be surgically excised. 

If you are concerned you have a plantar wart, the best course of action is to see your podiatrist and discuss the best treatment options with them.

Jason Khadavi, DPM
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