Plantar warts are common, superficial skin growths caused by human papillomavirus (HPV) types 1, 2, and 4. Plantar warts are thick hyperkeratotic papules / plaques that often form on pressure points such as the ball of the foot and the heel, but they may occur anywhere on the sole. Plantar warts can be asymptomatic; however, they may become callused and painful with pressure or with walking. They are slightly more common in females, young children, and immunocompromised patients.
HPV types 1, 2, and 4 are ubiquitous in the environment. The virus is frequently transmitted from person to person through exposure on locker room floors, public showers, and pool areas.
Plantar wart in Adult
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Synopsis
Codes
ICD10CM:
B07.0 – Plantar wart
SNOMEDCT:
63440008 – Plantar wart
B07.0 – Plantar wart
SNOMEDCT:
63440008 – Plantar wart
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- A clavus, or corn, is a painful hyperkeratotic lesion with a central core that lacks pinpoint thrombosed capillaries and retains normal skin dermatoglyphics. Clavi occur in sites of pressure and repeated friction.
- Foreign body reaction, which may have a history of trauma or inoculation.
- Acquired digital fibrokeratoma tends to have a smoother and more pedunculated appearance with a collarette of normal skin.
- Squamous cell carcinoma can arise in preexisting warts and may be recalcitrant to therapy.
- If the patient has recently traveled to a tropical area, consider tungiasis (infestation with a burrowing flea into the sole of the foot). Look for a firm, white papule with a central black dot.
- Amelanotic melanoma is a diagnostic challenge. Amelanotic melanomas may occur on the soles and toes and in the toe webs. They may present as skin-colored or pink macules, papules, or nodules (sometimes with scale).
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Management Pearls
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Therapy
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References
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Last Reviewed:08/07/2018
Last Updated:08/07/2018
Last Updated:08/07/2018
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Plantar wart in Adult