Verruca Pedis (Viral)

Question 1

What is verruca?

Answer 1

Warts = benign tumours of the epidermis caused by local infection with HPV (human papillomavirus)

Question 2

What types of HPV are associated with the foot? (verruca pedis/plantar warts/papillomas)

Answer 2

HPV types 1, 2, 4 & 7

Question 3

Verruca pedis - pathophysiology (how you get it)

Answer 3

Via. skin-to-skin contact and can spread via auto-inoculation (spread the wart yourself to another part of your own body)

Commonly spread in communal areas like: swimming pools, changing rooms etc.

Question 4

Verruca pedis - incubation period

Answer 4

1-20 months

Question 5

Verruca pedis - histopathology (what’s happening at the cellular level)

Answer 5

• Increased mitosis at basal layer of infected cells
• Increased keratinocytes in prickle cell layer
• Exaggeration of undulation of dermal-epidermal junction
• Capillaries drawn toward epidermis = highly vascular lesions - which may appear as black specks which bleed on debridement (Thrombosed Capillaries)

Question 6

Treatment of verucca

Answer 6

It can resolve without treatment.

Chemical = Salicylic acid (solution, gel, disc, ointment, paste) - keratolytic

Cryotherapy = low temps to destroy tissue

Immune-mediated = DNCB

Curettage = surgical procedure to scoop out

Electrosurgery

Question 7

How do you distinguish verruca from other skin conditions?

Answer 7

Verruca will cause disruptions to the skin lines // Thrombosed capillaries // Well defined borders