Let’s try a little word association. If the first thing that comes to mind when you see the title is a character from a classic 1968 film starring Gene Wilder as the curious American CEO of a psychedelic British candy company, then consider yourself pop-cultured. If, however, your first thought is of a coliform lesion that grows on the bottom of the feet of many of my NYC podiatry patients, then you have been spending too much time on these blogs. Now that I have your attention, let’s talk about the verruca plantaris, or the plantar wart.
A plantar wart is a viral infection of the skin that can occur just about anywhere in the body, but is most commonly seen on the hands and feet. Generally a wart develops after the HPV, or human papilloma virus, invades the skin through a small break in the skin integrity. And, yes, as many of my NYC podiatry patients suspect, the virus can be contracted in the gym, pool, club or even the salon. However, the virus is very common, so it’s hard to blame it on one source, or even one’s self. Some patients seem to be more susceptible to the infection, for as yet unknown reasons.
Like many viruses, after invading the skin, the virus inserts its own DNA into the host cell’s nucleus, thus creating a small viral factory within the skin. This not only allows the virus to make copies of itself, but it can do so virtually undetected. A raised coliform lesion usually develops that can be painful with pressure. Since the upper, or epidermal, layer of skin is devoid of blood vessels, the virus has to access the blood supply inherent in the dermal, or deeper layers of skin. This can be seen clinically as the small red dots on the surface of a wart.
Treatment consists of either tissue destructive methods such as freezing, surgical excision, blistering solutions, or laser. Other treatments, such as topical creams and an injection with small amounts of fungus are aimed at stimulating an immune response against the virus. The virus can get fairly entrenched in the skin and thus a little pesky, so full treatment can be a challenge.
So, if you have little viruses invading your skin like something out of Alien, don’t wait until they spread or become worse. Just like with kids, little particles=little problem; big particles=big problem.
See you in the office.
Ernest Isaacson
