Verruca - Verruca pedis-large (Viral wart)
What is a verruca? Verrucas and warts are small lumps on the skin.
Definition: A large benign ‘papillomatous/plaque like contagious skin lesion caused by human papillomavirus infection of epidermal (stratum germinativum) cells; induces increased mitosis of infected cells, hypertrophy of dermal papillae and rete pegs (villi formations) associated thickening of overlying epidermis with parakeratosis formation’ (Mooney, 2009:419).
Clinical Features:
Will bleed when on reduction, whereas corns tend not to. Verrucae hurt on sideways or lateral pressure, whilst corns are thought to hurt on direct pressure. A pinch test generally confirms diagnosis.
Cause:
Caused by the human papillomavirus infection of epidermal (stratum germinativum) cells and is transmitted by direct contact, possibly through small cuts or abrasions in the stratum corneum layer of the skin. (Mooney, 2009:419).
Management:
Treatments include topical to surgical: Liquid nitrogen (by freezing the infected cells); electrosurgery (after local anaesthetic, the use of an electrofied loop probe removes the epidermal layer and the verruca); needling (post local anaesthetic, a thick needle repeatedly punctures the deromoepidermal junction, to introduce the infection to the compliment system), chemotherapy and more recently, thermal laser treatment which burns the lesion (Johnston, 2015; Weber, 2015).
Refrences:
Bristow, I and Turner, R. (2009) ‘Dermatological assessment’ in Yeates, B. ed. Merriman’s assessment of the lower limb. Third Edition. London: Churchill Livinigstone Elsevier.pp 164-200.
Johnston, I (2015) ‘Verrucae Pedis (plantar warts)’. On line available: http://www.footmech.co.uk/common-podiatry-conditions/skin/verrucae-pedis/
(Accessed 12/08/15.)
Mooney, J (2009) Illustrated dictionary of Podiatry and Foot Science, Churchill Livingstone Elsevier, London.
Weber, C.A. (2013) ‘How to treat Recalcitrant Plantar Warts’. Podiatry Today. Vol. 26(7). On line available: http://www.podiatrytoday.com/how-treat-recalcitrant-plantar-warts#sthash.TxjohTzu.dpu