Chapter 119: Plantar Warts

Patient Story

A 15-year-old boy presents with painful growths on his right heel for approximately 6 months (Figure 119-1). It is painful to walk on and he would like it treated. He was diagnosed with multiple large plantar warts called mosaic warts. The lesions were treated with gentle paring with a #15 blade scalpel and liquid nitrogen therapy over a number of sessions. He and his mom were instructed on how to use salicylic acid plasters on the remaining warts.

Introduction

Plantar warts (verruca plantaris) are human papilloma virus (HPV) lesions that occur on the soles of the feet (Figures 119-1 to 119-5) and palms of the hands (Figure 119-6).

Synonyms

Palmoplantar warts, myrmecia.

Epidemiology

• Plantar warts affect mostly adolescents and young adults, affecting up to 10 percent of people in these age groups.¹

• Prevalence studies demonstrate a wide range of values, from 0.84 percent in the US² to 3.3 to 4.7 percent in the United Kingdom,³ to 24 percent in 16- to 18-year-olds in Australia.⁴

Etiology and Pathophysiology

• Plantar warts are caused by HPV.

• They usually occur at points ...