Enhanced Verifiable CPD from the
University of Birmingham

Dentaljuce Shorts: 500 words, 10 MCQs, on general medicine and surgery.

Plantar Wart

A plantar wart, also known as verruca myrmecia or verruca plantaris, is a common dermatological condition characterised by a wart occurring on the bottom of the foot or toes. The condition primarily falls under the specialties of dermatology and podiatry. Plantar warts are typically skin-coloured lesions that can be painful, especially when subjected to pressure, making walking difficult.

Signs and Symptoms

Plantar warts are generally similar in colour to the surrounding skin and often exhibit small black dots on their surfaces. These warts can appear singly or in clusters. They are commonly painful under pressure, complicating mobility.

A plantar wart: striae (fingerprints) go around the lesion.
A plantar wart: striae (fingerprints) go around the lesion.
Mosaic wart cluster
Mosaic wart cluster.
Young plantar warts
Young plantar warts.
30-year-old plantar wart
30-year-old plantar wart.
Deep, painful plantar warts
Deep, painful plantar warts.
Deep plantar wart on heel
Deep plantar wart on heel.

Cause

Plantar warts are benign epithelial tumours caused by human papillomavirus (HPV) types 1, 2, 4, 60, or 63, among others. The virus infects compromised skin through direct contact, often entering through minor abrasions. The incubation period can vary, and the warts may not become visible for several weeks or months. The pressure on the sole of the foot can push the wart inward, covered by a layer of hard skin, potentially causing pain if untreated. Warts can spread through autoinoculation or contaminated surfaces.

Diagnosis

Diagnosis is typically based on symptoms and visual examination. Plantar warts usually appear as small lesions resembling cauliflower, with tiny black petechiae in the centre. They are often painful when standing or walking and can be differentiated from calluses by observing the disruption of skin striations. Unlike calluses, plantar warts are painful when pressure is applied from the sides rather than directly.

Prevention

HPV spreads through direct and indirect contact with contaminated surfaces. Preventive measures include avoiding direct contact with communal showers, changing rooms, and not sharing shoes or towels. Wearing flip-flops in communal areas and covering warts while swimming can help reduce the spread. It is important to note that HPV vaccines such as Gardasil and Cervarix do not provide protection against the strains that cause plantar warts.

Treatment

Treatment is typically required only if the wart is causing symptoms. Various treatments have been found effective:

Medications

  • Salicylic Acid: Both over-the-counter and prescription formulations are available. The treatment involves keratolysis, peeling away dead skin cells. A 12-week treatment can lead to complete clearance in 10-15% of cases.
  • Formic Acid: Applied topically, it causes the body to reject the wart.
  • Fluorouracil Cream: A chemotherapy agent used for resistant warts, it blocks viral DNA and RNA production.
  • Bleomycin: Injected into deep warts, this chemotherapy drug destroys viral DNA or RNA but can have severe side effects.
Cryotherapy being applied to a plantar wart with a cotton swab
Cryotherapy being applied to a plantar wart with a cotton swab.

Surgery

  • Cryotherapy: Liquid nitrogen is used to freeze and destroy wart tissue.
  • Electrodesiccation and Surgical Excision: These methods may produce scarring.
  • Laser Surgery: Considered a last resort due to expense and pain.
  • Cauterisation: Effective but risks scarring and recurrence.
A 7 mm plantar wart surgically removed from the sole of a person's foot after other treatments failed
A 7 mm plantar wart surgically removed from the sole of a person's foot after other treatments failed.

Intralesional immunotherapy, involving injections of antigens, is now recommended as a second-line therapy, aiming to trigger an immune response against the wart virus.


Self-assessment MCQs (single best answer)

What is another name for a plantar wart?



What virus is responsible for causing plantar warts?



Which of the following HPV types is NOT typically associated with plantar warts?



What is a distinguishing feature of plantar warts compared to calluses?



Which treatment involves the use of liquid nitrogen to destroy wart tissue?



What preventive measure can help reduce the spread of plantar warts in communal shower areas?



Which medication is a chemotherapy agent used for resistant plantar warts?



What is the main reason plantar warts can be painful?



Which type of surgery is considered a last resort due to expense and pain for treating plantar warts?



Which treatment involves injecting antigens to trigger an immune response against the wart virus?



Dentaljuce

Dentaljuce provides Enhanced Continuing Professional Development (CPD) with GDC-approved Certificates for dental professionals worldwide.

Founded in 2009 by the award-winning Masters team from the School of Dentistry at the University of Birmingham, Dentaljuce has established itself as the leading platform for online CPD.

With over 100 high-quality online courses available for a single annual membership fee, Dentaljuce offers comprehensive e-learning designed for busy dental professionals.

The courses cover a complete range of topics, from clinical skills to patient communication, and are suitable for dentists, nurses, hygienists, therapists, students, and practice managers.

Dentaljuce features Dr. Aiden, a dentally trained AI-powered personal tutor available 24/7 to assist with queries and provide guidance through complex topics, enhancing the learning experience.

Check out our range of courses, or sign up now!

Membership Options

Dentaljuce offers a range of membership options…

Regular Membership

With enhanced CPD Certificates. Dentaljuce is brought to you by the award winning Masters team from the School of Dentistry, University of Birmingham, UK. All have won awards for web based learning and teaching and are recognised as leaders and innovators in this field, as well as being highly experienced clinical teachers. Full access to over 100 courses, no extras to pay.

Buy Now

£89.00 per year

Student Membership

No Certificates. With universities cutting down on traditional lectures, many students are currently having to rely more on online resources. If you don't need CPD Certificates, we are offering an amazing discount on your Dentaljuce personal membership fee. Special student price just £29 for 12 months individual membership.

Buy Now

£29.00 per year

This website is so great, I have been telling so many people. Fantastic.
DY

© Dentaljuce 2024 | Terms & Conditions | Privacy Policy

Recording CPD time: recorded.