Materiały źródłowe

• #1 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). […] Plantar warts, or verrucae plantaris, are cutaneous lesions on the plantar aspect of the foot that are caused by the infection of keratinocytes with the human papillomavirus (HPV). […] Once a plantar wart is established, it sheds HPV via desquamated epithelial cells. The viral particles can subsequently infect other sites and hosts. […] Current treatment methods have been used with variable success, as the lesions are notoriously resistant to treatment and recur frequently. […] The only preventive measures that have been established involve controlling exposure to HPV, which is often impractical given its ubiquitous nature. […] Once infection occurs, 3 outcomes are possible: clearance of the infection with resultant immunity to that particular HPV type, latent infection, or clinically manifested infection as a plantar wart.

• #2 Plantar Warts: Symptoms, Causes, Treatment & Removal

  https://my.clevelandclinic.org/health/diseases/24899-plantar-warts

  Plantar warts (verruca plantaris) are benign (not harmful) rough bumps that form on the soles of your feet. They develop when the human papillomavirus (HPV) enters a cut or break in your skin and causes an infection. […] HPV causes plantar warts. When HPV enters a cut or break in your skin, it causes a skin infection that forms a plantar wart. It may take two to six months after HPV exposure for plantar warts to appear.

• #3 Plantar wart – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_wart

  Plantar warts are benign epithelial tumors generally caused by infection by human papillomavirus types 1, 2, 4, 60, or 63, but also by types 57, 65, 66, and 156. […] The virus attacks compromised skin through direct contact, possibly entering through tiny cuts and abrasions in the stratum corneum (outermost layer of skin). […] After infection, warts may not become visible for several weeks or months. […] Because of pressure on the sole of the foot or finger, the wart is pushed inward and a layer of hard skin may form over the wart. […] A plantar wart can be painful if left untreated. […] Warts may spread through autoinoculation, by infecting nearby skin, or by contaminated walking surfaces.

• #4

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #5 Warts: How To Identify, Causes, Types, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15045-warts

  Plantar warts develop on the bottom of your feet and typically grow inward. […] HPV types 1, 2, 4, 27 and 57 cause plantar warts. […] Certain strains of the human papillomavirus (HPV) cause warts. The virus can enter your skin through small cuts and cause extra cell growth. The outer layer of your skin turns thicker and harder, forming a wart. Warts are more likely to infect moist and soft skin or injured skin. […] All warts come from HPV, but not all forms of HPV cause warts. The type of HPV that can progress to cancer (like cervical cancer) doesn’t cause warts.

• #6 Plantar wart – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_wart

  Plantar warts are benign epithelial tumors generally caused by infection by human papillomavirus types 1, 2, 4, 60, or 63, but also by types 57, 65, 66, and 156. […] The virus attacks compromised skin through direct contact, possibly entering through tiny cuts and abrasions in the stratum corneum (outermost layer of skin). […] After infection, warts may not become visible for several weeks or months. […] Because of pressure on the sole of the foot or finger, the wart is pushed inward and a layer of hard skin may form over the wart. […] A plantar wart can be painful if left untreated. […] Warts may spread through autoinoculation, by infecting nearby skin, or by contaminated walking surfaces.

• #7 Cutaneous warts (common, plantar, and flat warts) – UpToDate

  https://www.uptodate.com/contents/cutaneous-warts-common-plantar-and-flat-warts/print

  Human papillomaviruses (HPVs) infect epithelial tissues of skin and mucous membranes. The most common clinical manifestations of HPV infection are warts (verrucae). There are over 200 distinct HPV subtypes; some tend to infect specific body sites. HPV type 1 commonly infects the soles of the feet and produces plantar warts, while HPV types 6 and 11 infect the anogenital area and cause anogenital warts. […] Infection with human papillomavirus (HPV) occurs by direct skin contact, with maceration or sites of trauma predisposing patients to inoculation. Latent HPV infection also may occur in normal skin. The reservoir for HPV appears to be individuals with clinical or subclinical infection. […] The incubation period is approximately two to six months.

• #8 Plantar Warts (Foot Warts): How You Get Them and What They Look Like

  https://www.webmd.com/skin-problems-and-treatments/understanding-plantar-warts-basics

  Plantar warts, like all warts, are caused by certain strains of the human papillomavirus (HPV), which invades the skin through tiny cuts or scrapes. The warts may not appear for weeks or months after the initial exposure. […] You can raise your risk of plantar warts by going barefoot in places where wart-causing viruses tend to linger, such as locker rooms and swimming pools. […] The strain of the virus is not highly contagious, so it does not spread easily from person to person via direct contact.

• #9

  https://step1.medbullets.com/dermatology/112092/cutaneous-warts-verrucae

  transmitted through contact with infected skin of mucous membranes […] warts contain high viral load […] virus invades epidermal basal layer through microabrasions and are confined to epidermis […] incubation period is 2-6 months

• #10 Cutaneous warts (common, plantar, and flat warts) – UpToDate

  https://www.uptodate.com/contents/cutaneous-warts-common-plantar-and-flat-warts/print

  Human papillomaviruses (HPVs) infect epithelial tissues of skin and mucous membranes. The most common clinical manifestations of HPV infection are warts (verrucae). There are over 200 distinct HPV subtypes; some tend to infect specific body sites. HPV type 1 commonly infects the soles of the feet and produces plantar warts, while HPV types 6 and 11 infect the anogenital area and cause anogenital warts. […] Infection with human papillomavirus (HPV) occurs by direct skin contact, with maceration or sites of trauma predisposing patients to inoculation. Latent HPV infection also may occur in normal skin. The reservoir for HPV appears to be individuals with clinical or subclinical infection. […] The incubation period is approximately two to six months.

• #11 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. […] Events that disrupt the normal epithelial barrier increase the likelihood of developing warts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. […] Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. […] Warts, in general, are benign, but there are reports that sometimes they may become malignant and develop into what is known as verrucous carcinoma. […] The verrucous carcinoma is a slow-growing tumor and is classified as a well-differentiated squamous cell malignancy that is often mistaken for a common wart. […] Malignant change is rare with common warts but rarely one may encounter transformation to verrucous carcinoma, which is most common on the plantar surface.

• #12 Warts Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/warts

  Plantar warts. Rough, flattened, callus like growths, often with tiny black dots in the center; frequently tender; can disrupt your posture, resulting in leg or back pain. […] Warts are caused by various strains of a common virus in humans, the human papillomavirus (HPV). They are more likely to occur if the skin has been broken or damaged in some way. […] The following factors increase your risk of developing warts: Direct contact with warts or the fluid in warts (notably genital warts), Using communal facilities (such as locker rooms), Skin trauma, Diseases or drugs that weaken your immune system. […] Studies show that one half of cutaneous warts resolve spontaneously within one year, and about two-thirds within two years. Some research shows 70% of warts clear within 3 months without any treatment.

• #13 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Palmar and plantar warts are flattened by pressure and surrounded by cornified epithelium. They are often tender. Plantar warts in particular can make walking and standing uncomfortable. They can be distinguished from corns and calluses by their tendency to pinpoint bleeding when the surface is pared away.

• #14 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #15 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] Wart regression relies on the development of an effective cellular immune response. […] However, plantar warts may develop in an otherwise healthy person when HPV gains entry to the epithelium and evades the host’s immune response.

• #16 Nongenital Warts: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1133317-overview

  Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Currently, more than 100 types of HPV have been identified. […] The HPV virus infects the epithelium, and systemic dissemination of the virus does not occur. Viral replication occurs in differentiated epithelial cells in the upper level of the epidermis; however, viral particles can be found in the basal layer. […] Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences.

• #17 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #18

  https://step1.medbullets.com/dermatology/112092/cutaneous-warts-verrucae

  transmitted through contact with infected skin of mucous membranes […] warts contain high viral load […] virus invades epidermal basal layer through microabrasions and are confined to epidermis […] incubation period is 2-6 months

• #19 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #20 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] Wart regression relies on the development of an effective cellular immune response. […] However, plantar warts may develop in an otherwise healthy person when HPV gains entry to the epithelium and evades the host’s immune response.

• #21 Plantar wart – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_wart

  Plantar warts are benign epithelial tumors generally caused by infection by human papillomavirus types 1, 2, 4, 60, or 63, but also by types 57, 65, 66, and 156. […] The virus attacks compromised skin through direct contact, possibly entering through tiny cuts and abrasions in the stratum corneum (outermost layer of skin). […] After infection, warts may not become visible for several weeks or months. […] Because of pressure on the sole of the foot or finger, the wart is pushed inward and a layer of hard skin may form over the wart. […] A plantar wart can be painful if left untreated. […] Warts may spread through autoinoculation, by infecting nearby skin, or by contaminated walking surfaces.

• #22 A Closer Look at How Warts On Your Feet DevelopFacebookInstagram

  https://nunnallyderm.com/a-closer-look-at-how-warts-on-your-feet-develop/

  As the infection progresses, the wart begins to emerge as a small, rough bump on the sole of the foot. Over time, it can evolve, taking on a cauliflower-like texture with black pinpoints, which are small, clotted blood vessels. This growth can expand both outward and inward, embedding deeper into the skin. […] Plantar warts develop primarily on pressure points of the foot, such as the heel or ball. This pressure can cause warts to grow inward beneath a hard, thick layer of skin (callus). The altered skin structure can lead to discomfort, especially when walking or standing, as the body’s weight presses down on the wart. […] Plantar warts spread through direct contact with HPV-infected surfaces or skin. High-risk environments include moist areas where people walk barefoot, like locker rooms or swimming pools. Preventative measures include wearing footwear in such areas and maintaining good foot hygiene. People with compromised immune systems or those who frequently have wet or injured feet are more susceptible to developing warts.

• #23 Warts – APMA MAIN

  https://www.apma.org/patients-and-the-public/conditions-affecting-the-foot-and-ankle/warts/

  The virus that causes warts generally invades the skin through small or invisible cuts and abrasions. […] The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. […] The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities. […] Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. […] Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. […] It is important to note that warts can be very resistant to treatment and have a tendency to reoccur. […] When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel, for example), they can be the source of sharp, burning pain.

• #24 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management – Journal of Osteopathic Medicine

  https://jom.osteopathic.org/abstract/plantar-warts-epidemiology-pathophysiology-and-clinical-management/

  Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). […] Plantar warts shed HPV, which can then infect other sites in the plantar region or spread to other people. […] Given the high propensity for treatment resistance of plantar warts and no established, practical, and reliable method of prevention, HPV prophylaxis for populations that demonstrate high rates of plantar warts may be of benefit in controlling the spread of lesions.

• #25 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #26 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #27 Destructive therapies for cutaneous warts: A review of the evidence

  https://www1.racgp.org.au/ajgp/2022/october/destructive-therapies-for-cutaneous-warts

  Common warts (Verruca vulgaris), plantar warts (Verruca plantaris) and flat/plane warts (Verruca plana), collectively known as cutaneous warts, are benign growths of the skin caused by the human papillomavirus (HPV). […] A break in the epidermal barrier of the skin allows entry of HPV and subsequent infection of basal epithelial cells. HPV replicates alongside the natural lifecycle of epithelial cells, and is eventually released from desquamated keratinocytes on the surface of warts, potentially infecting other sites via direct contact or through fomites. […] Damaging or destroying the infected epithelium causes HPV cell death. The subsequent antigen exposure and presentation might also induce an immune response.

• #28 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  The viral antigen is first taken up by Langerhans cells of the epidermis, which then enter the regional lymphatic drainage and thereby enter a lymph node. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] Plantar warts present a significant problem to athletes, as the pain can affect the athlete’s ability to ambulate. […] It is imperative that physicians consider that patients who present with large numbers of plantar warts or treatment-resistant plantar warts may have an underlying immunodeficiency and that patients with an established immunodeficiency and plantar warts may harbor a malignant neoplasm within the lesion. […] Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #29 Wart – Wikipedia

  https://en.wikipedia.org/wiki/Wart

  Warts are caused by the human papillomavirus (HPV). […] Plantar warts (verruca) HPV type 1 (most common); also types 2, 4, 27, 28, and others. […] Common warts have a characteristic appearance under the microscope. They have thickening of the stratum corneum (hyperkeratosis), thickening of the stratum spinosum (acanthosis), thickening of the stratum granulosum, rete ridge elongation, and large blood vessels at the dermoepidermal junction. […] The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen. […] HPV vaccines do not currently protect against the virus strains responsible for plantar warts (verrucae).

• #30 Warts: How To Identify, Causes, Types, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15045-warts

  Plantar warts develop on the bottom of your feet and typically grow inward. […] HPV types 1, 2, 4, 27 and 57 cause plantar warts. […] Certain strains of the human papillomavirus (HPV) cause warts. The virus can enter your skin through small cuts and cause extra cell growth. The outer layer of your skin turns thicker and harder, forming a wart. Warts are more likely to infect moist and soft skin or injured skin. […] All warts come from HPV, but not all forms of HPV cause warts. The type of HPV that can progress to cancer (like cervical cancer) doesn’t cause warts.

• #31

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #32 Warts – APMA MAIN

  https://www.apma.org/patients-and-the-public/conditions-affecting-the-foot-and-ankle/warts/

  The virus that causes warts generally invades the skin through small or invisible cuts and abrasions. […] The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. […] The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities. […] Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. […] Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. […] It is important to note that warts can be very resistant to treatment and have a tendency to reoccur. […] When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel, for example), they can be the source of sharp, burning pain.

• #33

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #34 Silent Spreaders: Story Behind Contagious Plantar Warts

  https://edermgroup.com/dermatology-blog/silent-spreaders-story-behind-contagious-plantar-warts

  Plantar warts, or verrucae warts, are hard, grainy skin growths that appear on the heels or balls of the feet. […] These growths are caused by specific strains of the human papillomavirus (HPV), which enters the body through tiny cuts or breaks in the skin on the bottom of the feet. […] Understanding the HPV infection and its manifestation as plantar warts is the first step in managing this common dermatological issue. […] Plantar warts are indeed contagious. […] The virus thrives in warm, moist environments, making communal areas hotspots for transmission. […] Recognizing the modes of transmission can significantly aid in the prevention of plantar warts. […] Understanding the facts about plantar warts is essential for effective prevention and treatment. […] Plantar warts, caused by the human papillomavirus (HPV), are indeed contagious but manageable with the right approach to prevention and treatment. […] Understanding their nature, how they spread, and the effective ways to treat them can alleviate much of the anxiety associated with these common skin growths.

• #35 Plantar warts | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/plantar-warts?content_id=CON-20305521

  Plantar warts are caused by an infection with HPV in the outer layer of skin on the soles of the feet. The warts develop when the virus enters through tiny cuts, breaks or weak spots on the bottom of the foot. […] HPV is very common, and more than 100 kinds of the virus exist. But only a few of them cause warts on the feet. Other types of HPV are more likely to cause warts on other areas of your skin or on mucous membranes. […] The HPV strains that cause plantar warts aren’t highly contagious. So the virus isn’t easily spread by direct contact from one person to another. But it thrives in warm, moist places, so you might get the virus by walking barefoot around swimming pools or locker rooms. If the virus spreads from the first site of infection, more warts may grow.

• #36

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #37 What causes plantar warts?

  https://blog.walgreens.com/health/skin-health-conditions/what-causes-plantar-warts.html

  Plantar warts are caused by the human papillomavirus, or HPV. HPV enters the top layer of skin through tiny cuts and causes excessive cell growth. […] Tiny black dots or seeds may also appear inside plantar warts. These are actually clogged blood vessels. […] Human papillomaviruses multiply in the skin, but that doesn’t necessarily mean you’ll develop more warts. However, if you’ve had one wart, you may be more likely to have more later on. Even if you have a plantar wart removed, the virus may remain in the skin and could cause another wart in the future.

• #38

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #39 Nongenital Warts: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1133317-overview

  Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Currently, more than 100 types of HPV have been identified. […] The HPV virus infects the epithelium, and systemic dissemination of the virus does not occur. Viral replication occurs in differentiated epithelial cells in the upper level of the epidermis; however, viral particles can be found in the basal layer. […] Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences.

• #40 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  If this process fails, a persistent plantar wart is established. […] Plantar wart management strategies are met with high degrees of variability in success rates and often fail to adequately manage a recalcitrant wart. Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #41 Plantar Warts Background Information

  https://verrica.com/key_publications/plantar-warts-background-information/

  Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). Ubiquitous in our environment, asymptomatic infection with HPV occurs frequently, with most infections controlled or cleared by cellular and humoral immune responses. […] Plantar warts shed HPV, which can then infect other sites in the plantar region or spread to other people. Although controlling risk factors is useful in preventing infection, the pervasive nature of HPV makes these preventive measures frequently impractical. This literature review outlines the current knowledge regarding the relationship between plantar wart pathophysiology, HPV transmission, and epidemiologic characteristics. […] Given the high propensity for treatment resistance of plantar warts and no established, practical, and reliable method of prevention, HPV prophylaxis for populations that demonstrate high rates of plantar warts may be of benefit in controlling the spread of lesions.

• #42 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Palmar and plantar warts are flattened by pressure and surrounded by cornified epithelium. They are often tender. Plantar warts in particular can make walking and standing uncomfortable. They can be distinguished from corns and calluses by their tendency to pinpoint bleeding when the surface is pared away.

• #43 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  The viral antigen is first taken up by Langerhans cells of the epidermis, which then enter the regional lymphatic drainage and thereby enter a lymph node. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] Plantar warts present a significant problem to athletes, as the pain can affect the athlete’s ability to ambulate. […] It is imperative that physicians consider that patients who present with large numbers of plantar warts or treatment-resistant plantar warts may have an underlying immunodeficiency and that patients with an established immunodeficiency and plantar warts may harbor a malignant neoplasm within the lesion. […] Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #44 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Palmar and plantar warts are flattened by pressure and surrounded by cornified epithelium. They are often tender. Plantar warts in particular can make walking and standing uncomfortable. They can be distinguished from corns and calluses by their tendency to pinpoint bleeding when the surface is pared away.

• #45 Nongenital Warts: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1133317-overview

  Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Currently, more than 100 types of HPV have been identified. […] The HPV virus infects the epithelium, and systemic dissemination of the virus does not occur. Viral replication occurs in differentiated epithelial cells in the upper level of the epidermis; however, viral particles can be found in the basal layer. […] Warts are caused by HPV, which is a double-stranded, circular, supercoiled DNA virus enclosed in an icosahedral capsid and comprising 72 capsomers. More than 100 types of HPV have been identified. […] Approximately 65% of warts disappear spontaneously within 2 years. […] Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain recurrences.

• #46 Warts Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/warts

  Plantar warts. Rough, flattened, callus like growths, often with tiny black dots in the center; frequently tender; can disrupt your posture, resulting in leg or back pain. […] Warts are caused by various strains of a common virus in humans, the human papillomavirus (HPV). They are more likely to occur if the skin has been broken or damaged in some way. […] The following factors increase your risk of developing warts: Direct contact with warts or the fluid in warts (notably genital warts), Using communal facilities (such as locker rooms), Skin trauma, Diseases or drugs that weaken your immune system. […] Studies show that one half of cutaneous warts resolve spontaneously within one year, and about two-thirds within two years. Some research shows 70% of warts clear within 3 months without any treatment.

• #47 Clinical Resolution of Plantar Warts Using the Needling Technique

  https://www.mdpi.com/2079-9721/13/2/50

  Plantar warts are common lesions found in clinical practice, produced by an HPV (Human Papilloma Virus) infection, particularly types that affect the skin, such as HPV-1, HPV-27, and HPV-57. […] The needling technique has been reviewed in the last few years, without meeting agreement yet on its effectiveness. Historically, since this technique was first documented in 1969, its effect has been suggested to rely on immunological mechanisms, activating an inflammatory response to the trauma. […] It can be assumed to be true, considering the fact that the natural course of an HPV infection downregulates the immune system through the expression of E5–E7 proteins and maintains a low copy number in the basal layer to evade immune detection. […] Since the infection naturally requires an immune response mediated by Langerhans cells and inflammatory cytokines, it is plausible that artificially damaging the lesional tissue with the needling technique could activate this response and contribute to viral clearance.

• #48 Clinical Resolution of Plantar Warts Using the Needling Technique

  https://www.mdpi.com/2079-9721/13/2/50

  Plantar warts are common lesions found in clinical practice, produced by an HPV (Human Papilloma Virus) infection, particularly types that affect the skin, such as HPV-1, HPV-27, and HPV-57. […] The needling technique has been reviewed in the last few years, without meeting agreement yet on its effectiveness. Historically, since this technique was first documented in 1969, its effect has been suggested to rely on immunological mechanisms, activating an inflammatory response to the trauma. […] It can be assumed to be true, considering the fact that the natural course of an HPV infection downregulates the immune system through the expression of E5–E7 proteins and maintains a low copy number in the basal layer to evade immune detection. […] Since the infection naturally requires an immune response mediated by Langerhans cells and inflammatory cytokines, it is plausible that artificially damaging the lesional tissue with the needling technique could activate this response and contribute to viral clearance.

• #49 What happens to Untreated Plantar Warts | Direct Care Kansas City Area Podiatrist | Joel D Foster DPM PC

  https://www.joelfosterdpm.com/library/what-happens-to-untreated-plantar-warts-joel-d-foster-dpm.cfm

  Warts are caused by a viral infection in the uppermost layers of skin. […] The issue with plantar warts is that the immune system really doesnt patrol the uppermost layers of skin with anywhere near the kind of vigilance that it does for more critical organs and systems with a more robust blood supply. […] As a result, the wart-causing virus can operate for months, years, or even indefinitely in its small region of skin before the immune system can build up an effective counterattack. […] Swift Microwave Therapy is a new, effective treatment option for warts that works by getting your immune system active and involved in the fight. A short burst of microwaves into the top layers of skinjust a couple of secondsis all we need to treat the damaged tissue and draw the immune systems attention to the once-hidden virus.

• #50 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  If this process fails, a persistent plantar wart is established. […] Plantar wart management strategies are met with high degrees of variability in success rates and often fail to adequately manage a recalcitrant wart. Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #51 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] Wart regression relies on the development of an effective cellular immune response. […] However, plantar warts may develop in an otherwise healthy person when HPV gains entry to the epithelium and evades the host’s immune response.

• #52 Plantar Warts: Symptoms, Causes, Remuval & Treatment | Ada

  https://ada.com/conditions/plantar-warts/

  Plantar warts are caused by the human papillomavirus (HPV) an umbrella term for a group of viruses that affect the skin. The virus causes an excess of the protein keratin to develop on the surface of the skin, resulting in warts. […] The virus typically enters the skin through small cuts or weak spots in the outermost layer of the skin and can take a number of weeks or months to produce visible warts. […] Damaged or wet skin is most susceptible to infection. […] If the warts are persistent, painful or if they spread, treatment may be recommended to remove them. […] The use of salicylic acid and cryotherapy are the most common treatment methods. […] Immunotherapy: This treatment method involves injecting the warts with antigens that stimulate the immune system into fighting the HPV infection. It may help prevent repeat outbreaks in those with recurring warts. […] In extreme cases surgical removal may be necessary if the plantar warts do not respond to other methods.

• #53 Plantar warts: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/325813

  Plantar warts are small, noncancerous growths on the soles that occur due to a human papillomavirus (HPV) strain. […] When skin cells become infected with HPV, the virus tends to make them grow quicker than the cells in surrounding areas, causing a wart to form. […] The HPV virus that causes plantar warts is contagious, which means that it can spread between people, particularly in warm, wet environments. […] If warts do not respond to other treatments, immunotherapy can stimulate the immune system to fight off the HPV virus that is responsible for their development. […] Intralesional candida injection is another type of treatment that studies have proven to be quite successful as an off label treatment for warts. It essentially involves the injection of the antigen from the yeast Candida into one or two warts in the affected area. […] This antigen ramps up the immune system, which helps resolve the injected wart, as well as other warts in the area.

• #54 Unique and Promising Treatment for Resistant Plantar Warts

  https://michiganpodiatry.com/blog/resistant-plantar-warts/

  The Human Papillomavirus (HPV) causes warts. […] Plantar warts tend to grow where there is pressure and friction. […] For resistant plantar warts, your doctor may try laser therapy, cryotherapy, cantharidin liquid, or other techniques. […] If these therapies fail, then another treatment is intralesional injections of Candida Albicans Antigen. […] With injection therapy, the body’s immune system learns that wart tissue is abnormal starting an immunostimulatory effect. […] Your own immune cells break down the Wart Virus. […] Unlike other treatments, if the warts go away with injection therapy, they rarely return. […] According to the American Family Physician articles, Candidal Injections are a promising treatment for plantar warts.

• #55 Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh – IP Indian J Clin Exp Dermatol

  https://www.ijced.org/article-details/8428

  Warts are the viral infection of the skin caused by Human Papilloma virus, which manifest in the form of verrucous growth over the surface of skin. HPV is a DNA virus that infects skin or mucosal cells. It infects the basal layer of epithelium, possibly the stem cells, but viral replication takes place only in fully differentiated keratinocytes i.e. cells of the stratum spinosum and stratum granulosum. […] Currently, a newer form of therapy is in trend which is known as immunotherapy. This involves the amplification or activation of the patients immune system with the help of immunomodulators. Intralesional immunotherapy uses purified protein derivative, candida antigen, trychophytin skin test antigen. MMR vaccine, or Mw vaccine, to treat warts. […] In Intralesional immunotherapy, a delayed hypersensitivity response develops to the injected antigen and the wart tissue. It is usually seen that there is development of TH1 cytokines which activate cytotoxic and NK cells to eradicate the HPV infection.

• #56 Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh – IP Indian J Clin Exp Dermatol

  https://www.ijced.org/article-details/8428

  Intralesional immunotherapy carries an advantage of developing or augmenting the host immune response to the wart antigen. So, it is helpful for destroying the wart infection at the disease as well as at the remote site. It confers immunity to wart antigen for future also, so it is helpful in reducing the chance of recurrence also. […] How the PPD clears the wart, its mechanism is not very well established but various studies suggest that when PPD is injected into the wart tissue, it induces the release of various pro-inflammatory chemicals. These in turn, cause activation of APC (antigen presenting cell), which recognize and then process the HPV at the local site. […] This leads to the development of robust adaptive immune reaction against mycobacterium tuberculosis as well as against HPV infection. It is mediated by Th1 cytokines such as interleukin-4, 5,8, IFN- and TNF-?. An increase in IL-12 as a process in boosting the cell mediated immunity also contributes to the mechanism of action.

• #57 Five Cases of Recalcitrant Plantar Warts Successfully Treated with Imiquimod 5% Cream | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-five-cases-recalcitrant-plantar-warts-articulo-S1578219013001558

  Plantar warts are caused by infection with human papillomavirus (HPV) types 1, 2, 4, or 57. Their treatment can be difficult when the lesion is located in a callused site subjected to significant pressure or when several warts are grouped together. […] Imiquimod (1-[2methypropyl]-1 H-imidazole [4,5c]quinolin-4amine) is an immune response modifier with antiviral and antitumor activity mediated by the induction of helper T (Th) 1 cytokines. The exact mechanism of action remains unclear, but activation of the immune system is thought to be responsible for eradicating the virus and curing the warts. […] Imiquimod therapy is less traumatic than ablative treatments, which often involve local tissue destruction and pain, and any local inflammatory reactions tend to be mild and transitory. […] Imiquimod also stimulates immunological memory for HPV and, as a result, wart recurrence after treatment with this drug may be lower than with other therapies.

• #58 Clinical Resolution of Plantar Warts Using the Needling Technique

  https://www.mdpi.com/2079-9721/13/2/50

  Plantar warts are common lesions found in clinical practice, produced by an HPV (Human Papilloma Virus) infection, particularly types that affect the skin, such as HPV-1, HPV-27, and HPV-57. […] The needling technique has been reviewed in the last few years, without meeting agreement yet on its effectiveness. Historically, since this technique was first documented in 1969, its effect has been suggested to rely on immunological mechanisms, activating an inflammatory response to the trauma. […] It can be assumed to be true, considering the fact that the natural course of an HPV infection downregulates the immune system through the expression of E5–E7 proteins and maintains a low copy number in the basal layer to evade immune detection. […] Since the infection naturally requires an immune response mediated by Langerhans cells and inflammatory cytokines, it is plausible that artificially damaging the lesional tissue with the needling technique could activate this response and contribute to viral clearance.

• #59 Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh – IP Indian J Clin Exp Dermatol

  https://www.ijced.org/article-details/8428

  Warts are the viral infection of the skin caused by Human Papilloma virus, which manifest in the form of verrucous growth over the surface of skin. HPV is a DNA virus that infects skin or mucosal cells. It infects the basal layer of epithelium, possibly the stem cells, but viral replication takes place only in fully differentiated keratinocytes i.e. cells of the stratum spinosum and stratum granulosum. […] Currently, a newer form of therapy is in trend which is known as immunotherapy. This involves the amplification or activation of the patients immune system with the help of immunomodulators. Intralesional immunotherapy uses purified protein derivative, candida antigen, trychophytin skin test antigen. MMR vaccine, or Mw vaccine, to treat warts. […] In Intralesional immunotherapy, a delayed hypersensitivity response develops to the injected antigen and the wart tissue. It is usually seen that there is development of TH1 cytokines which activate cytotoxic and NK cells to eradicate the HPV infection.

• #60 Five Cases of Recalcitrant Plantar Warts Successfully Treated with Imiquimod 5% Cream | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-five-cases-recalcitrant-plantar-warts-articulo-S1578219013001558

  Plantar warts are caused by infection with human papillomavirus (HPV) types 1, 2, 4, or 57. Their treatment can be difficult when the lesion is located in a callused site subjected to significant pressure or when several warts are grouped together. […] Imiquimod (1-[2methypropyl]-1 H-imidazole [4,5c]quinolin-4amine) is an immune response modifier with antiviral and antitumor activity mediated by the induction of helper T (Th) 1 cytokines. The exact mechanism of action remains unclear, but activation of the immune system is thought to be responsible for eradicating the virus and curing the warts. […] Imiquimod therapy is less traumatic than ablative treatments, which often involve local tissue destruction and pain, and any local inflammatory reactions tend to be mild and transitory. […] Imiquimod also stimulates immunological memory for HPV and, as a result, wart recurrence after treatment with this drug may be lower than with other therapies.

• #61 Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh – IP Indian J Clin Exp Dermatol

  https://www.ijced.org/article-details/8428

  Intralesional immunotherapy carries an advantage of developing or augmenting the host immune response to the wart antigen. So, it is helpful for destroying the wart infection at the disease as well as at the remote site. It confers immunity to wart antigen for future also, so it is helpful in reducing the chance of recurrence also. […] How the PPD clears the wart, its mechanism is not very well established but various studies suggest that when PPD is injected into the wart tissue, it induces the release of various pro-inflammatory chemicals. These in turn, cause activation of APC (antigen presenting cell), which recognize and then process the HPV at the local site. […] This leads to the development of robust adaptive immune reaction against mycobacterium tuberculosis as well as against HPV infection. It is mediated by Th1 cytokines such as interleukin-4, 5,8, IFN- and TNF-?. An increase in IL-12 as a process in boosting the cell mediated immunity also contributes to the mechanism of action.

• #62 Plantar Warts and Palmar Warts: Treatments and Causes

  https://www.webmd.com/skin-problems-and-treatments/plantar-warts-palmar-warts

  Plantar warts and palmar warts are noncancerous skin growths caused by a viral infection in the top layer of the skin. The culprit is a strain of virus called human papillomavirus (HPV). […] The strain that causes warts on your hands or feet isn’t the same HPV strain that causes genital warts. […] Warts are spread from person to person. The transmission can be indirect. […] A person’s risk of getting a wart varies. Those with a weakened immune system are more likely to get it. […] Some people mistakenly think plantar warts or palmar warts are malignant. But they aren’t harmful. […] With time, the wart will likely disappear on its own, thanks to your immune system.

• #63 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Palmar and plantar warts are flattened by pressure and surrounded by cornified epithelium. They are often tender. Plantar warts in particular can make walking and standing uncomfortable. They can be distinguished from corns and calluses by their tendency to pinpoint bleeding when the surface is pared away.

• #64 Plantar Warts: Causes, Symptoms & Treatment | The Feet People Podiatry

  https://www.thefeetpeople.com.au/symptoms-we-treat/plantar-warts/

  Warts are a growth on the skin that is caused by a viral infection from the Human Papilloma Virus (HPV). […] HPV is a slow-growing virus that is transmitted by direct or indirect contact. This means you could get it directly from someone who has the virus (e.g. skin to skin contact), or by sharing floor surfaces, shoes or socks with someone infected. However, not everyone that comes in contact with the virus will develop warts, as each person’s immune system responds differently to the viral strains. […] This virus attacks the skin on the bottom of your feet, causing the top layer of skin to grow rapidly and form a fleshy raised lesion.

• #65 The Link Between a Weakened Immune System and Plantar Warts : Town Center Foot & Ankle: Podiatry

  https://www.tcfootandankle.com/blog/the-link-between-a-weakened-immune-system-and-plantar-warts

  Warts that appear on your feet are known as plantar warts. […] Did you know that warts are the result of a viral infection? […] The human papillomavirus (HPV) is the source of plantar warts. […] A weaker immune system might not be able to protect you from HPV and plantar warts. […] The infection can linger in your body for years at a time, causing recurring outbreaks. […] Some medications can also suppress your immune system, leaving you vulnerable to infections like HPV and plantar warts.

• #66 Stubborn Plantar Warts Expert Treatment in North Seattle | Foot and Ankle Center of Lake City

  https://www.bergdpm.com/practice_areas/expert-treatment-for-plantar-warts-in-north-seattle.cfm

  Plantar warts are caused by HPV or the Human Papillomavirus. The virus that causes plantar warts thrives in warm, moist environments. […] Like any other infectious lesion, plantar warts are spread by touching, scratching, or by sharing towels, razors, or other personal items. […] People most at risk for warts are children, elderly people, and those with a weakened immune system such as those with Type 1 or Type 2 diabetes. Also, because HPV requires an entry point into the body, those with recurring cuts, cracks, or scrapes on their feet are more likely to get infected. […] Swift treats the virus that causes warts, not the warts themselves it’s the best treatment to prevent them from recurring.

• #67 Warts – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/viral-skin-diseases/warts

  Warts are cutaneous lesions caused by human papillomavirus (HPV) infection; there are over 100 HPV subtypes. […] Trauma and maceration facilitate initial epidermal inoculation. Spread can then occur by autoinoculation. Local and systemic immune factors also appear to influence spread; immunosuppressed patients (especially those with suppressed cellular immunity, [eg, HIV infection or a kidney transplant or those with a history of tumor-suppressive immunotherapy]) are at particular risk of developing generalized lesions that are difficult to treat. […] Cellular immunity by CD8+ T-cells is crucial for established infection to regress. However, intact humoral immunity can also provide resistance to HPV infection. […] Palmar and plantar warts are flattened by pressure and surrounded by cornified epithelium. They are often tender. Plantar warts in particular can make walking and standing uncomfortable. They can be distinguished from corns and calluses by their tendency to pinpoint bleeding when the surface is pared away.

• #68 The Link Between a Weakened Immune System and Plantar Warts : Town Center Foot & Ankle: Podiatry

  https://www.tcfootandankle.com/blog/the-link-between-a-weakened-immune-system-and-plantar-warts

  Warts that appear on your feet are known as plantar warts. […] Did you know that warts are the result of a viral infection? […] The human papillomavirus (HPV) is the source of plantar warts. […] A weaker immune system might not be able to protect you from HPV and plantar warts. […] The infection can linger in your body for years at a time, causing recurring outbreaks. […] Some medications can also suppress your immune system, leaving you vulnerable to infections like HPV and plantar warts.

• #69

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #70 Plantar Warts – Allentown Family Foot Care

  https://affc.com/plantar-warts/

  Plantar Warts are seen in all age groups, but they are most common between the ages of 12 and 16. […] The foot is especially vulnerable to irritation and injury either from footwear or contact with the ground. A small break or crack in the skin will allow the virus virus to be introduced. […] Plantar Warts tend to be more resistant because the skin on the bottom of the foot is thicker than elsewhere on the body. This makes it difficult for topical OTC products to penetrate the skin and become effective. […] There is no one superior treatment for Plantar Warts. Even medical grade treatments such as liquid nitrogen (beetle juice) and surgical excision carry a risk of recurrence. […] Early diagnosis and treatment of a Plantar Wart is helpful in achieving the desired success and elimination of the problem.

• #71 Microwave therapy for the treatment of plantar warts | Journal of Foot and Ankle Research | Full Text

  https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-023-00638-8

  The analysis has also shown that lesion resolution is associated with a younger age which is consistent with existing research where both natural resolution and therapeutic cure rates for plantar warts across a number of different therapies are higher in younger populations. […] Although participants reported considerable pain during the application of microwave therapy, on departure from the appointment their pain levels had reduced to baseline, highlighting the short-lived nature of pain associated with this treatment. […] Participant-reported pain during treatment was significantly higher for unresolved lesions compared to those that resolved, which was likely due to the greater average joules used per treatment session for these more recalcitrant lesions. […] In conclusion, this retrospective study of 45 participants has shown that plantar warts may be resolved with two to three sessions of microwave therapy, which may be more successful in younger populations.

• #72 Understanding Causes and Treatment of Plantar Wartschevron-leftchevron-rightchevron-upchevron-rightchevron-leftarrow-backstarphonequotecheckbox-checkedsearchwrenchinfoshieldplayconnectionmobilecoin-dollarspoon-knifeticketpushpinlocationgiftfirefeedbubbles

  https://www.advancedfootdocs.com/blog/what-is-a-plantar-wart/

  Plantar warts are benign growths on the feet caused by infection with human papillomavirus, also called HPV. […] Although harmless, plantar warts can be extremely contagious. […] Swimmers are also at higher risk for HPV infection and the formation of plantar warts because they may pick up the virus from showers or pool decks if protective footwear is not worn.

• #73 Everything you need to know about plantar warts – Arizona Foot Doctors

  https://arizonafootdoctors.com/guide-plantar-warts/

  These warts are contagious. When you have one, you can spread the virus by touching the wart and then touching other parts of your body or by trying to cut the wart out yourself. This may lead to more warts! You can also spread the virus if you share footwear or other items that have come into contact with the wart or walk barefoot while you have a plantar wart. […] The virus that causes this condition survives best in warm and moist environments. If you walk barefoot in a locker room or public shower or around a swimming pool, you risk getting infected. However, not everyone is vulnerable to the virus. People’s immune systems react differently when exposed to HPV. Some people who get exposed to it never become infected, while others do. You can even see these differences in people from the same family!

• #74 Microwave therapy for the treatment of plantar warts | Journal of Foot and Ankle Research | Full Text

  https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-023-00638-8

  The analysis has also shown that lesion resolution is associated with a younger age which is consistent with existing research where both natural resolution and therapeutic cure rates for plantar warts across a number of different therapies are higher in younger populations. […] Although participants reported considerable pain during the application of microwave therapy, on departure from the appointment their pain levels had reduced to baseline, highlighting the short-lived nature of pain associated with this treatment. […] Participant-reported pain during treatment was significantly higher for unresolved lesions compared to those that resolved, which was likely due to the greater average joules used per treatment session for these more recalcitrant lesions. […] In conclusion, this retrospective study of 45 participants has shown that plantar warts may be resolved with two to three sessions of microwave therapy, which may be more successful in younger populations.

• #75

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #76 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  The viral antigen is first taken up by Langerhans cells of the epidermis, which then enter the regional lymphatic drainage and thereby enter a lymph node. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] Plantar warts present a significant problem to athletes, as the pain can affect the athlete’s ability to ambulate. […] It is imperative that physicians consider that patients who present with large numbers of plantar warts or treatment-resistant plantar warts may have an underlying immunodeficiency and that patients with an established immunodeficiency and plantar warts may harbor a malignant neoplasm within the lesion. […] Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #77 Warts – APMA MAIN

  https://www.apma.org/patients-and-the-public/conditions-affecting-the-foot-and-ankle/warts/

  The virus that causes warts generally invades the skin through small or invisible cuts and abrasions. […] The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. […] The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities. […] Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. […] Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. […] It is important to note that warts can be very resistant to treatment and have a tendency to reoccur. […] When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel, for example), they can be the source of sharp, burning pain.

• #78 Stand On These Facts About Plantar Warts

  https://fldscc.com/stand-on-these-facts-about-plantar-warts/

  Plantar warts are growths that form on the heels and soles of the feet. They are caused by the same virus as common warts the human papillomavirus (HPV). HPV is a viral infection that produces skin or mucous membrane warts. The virus does this by excessively producing keratin, a protein that makes up the top layer of skin. This rapid cell growth generates a buildup of thick, hard skin in the infected area. […] Both types of plantar warts can cause pain and discomfort to the infected area as well as surrounding skin. This may cause someone to walk differently, or even change their posture to accommodate for the injury to the foot. […] HPV can enter the body through skin breaks like cuts or scrapes. The virus thrives in moist skin environments that are wounded. […] Like regular warts, plantar warts are contagious. If you pick or scratch at a plantar wart, you can spread the virus to your fingernails, and other parts of your own body. Skin-to-skin contact and sharing personal hygiene items like razors, towels, and clothes also allow for spreading. […] Most warts are harmless and do not require treatment. They resolve on their own in children and adults, although warts on adults can take up to several years to disappear. […] Warts can be removed if they become painful, irritating, or if they start to multiply.

• #79 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  The viral antigen is first taken up by Langerhans cells of the epidermis, which then enter the regional lymphatic drainage and thereby enter a lymph node. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] Plantar warts present a significant problem to athletes, as the pain can affect the athlete’s ability to ambulate. […] It is imperative that physicians consider that patients who present with large numbers of plantar warts or treatment-resistant plantar warts may have an underlying immunodeficiency and that patients with an established immunodeficiency and plantar warts may harbor a malignant neoplasm within the lesion. […] Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #80 Warts Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/warts

  Plantar warts. Rough, flattened, callus like growths, often with tiny black dots in the center; frequently tender; can disrupt your posture, resulting in leg or back pain. […] Warts are caused by various strains of a common virus in humans, the human papillomavirus (HPV). They are more likely to occur if the skin has been broken or damaged in some way. […] The following factors increase your risk of developing warts: Direct contact with warts or the fluid in warts (notably genital warts), Using communal facilities (such as locker rooms), Skin trauma, Diseases or drugs that weaken your immune system. […] Studies show that one half of cutaneous warts resolve spontaneously within one year, and about two-thirds within two years. Some research shows 70% of warts clear within 3 months without any treatment.

• #81

  https://bpac.org.nz/bpj/2014/december/plantar-warts.aspx

  Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57. […] Although plantar warts are not usually associated with serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma. […] HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts are very prevalent in organ transplant recipients. […] Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.

• #82 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. […] Events that disrupt the normal epithelial barrier increase the likelihood of developing warts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. […] Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. […] Warts, in general, are benign, but there are reports that sometimes they may become malignant and develop into what is known as verrucous carcinoma. […] The verrucous carcinoma is a slow-growing tumor and is classified as a well-differentiated squamous cell malignancy that is often mistaken for a common wart. […] Malignant change is rare with common warts but rarely one may encounter transformation to verrucous carcinoma, which is most common on the plantar surface.

• #83 Wart – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431047/

  Warts are benign lesions caused by the human papillomavirus (HPV) that occur in the mucosa and skin. […] Warts are caused by the human papillomavirus (HPV), with over 100 types of HPV identified. […] Events that disrupt the normal epithelial barrier increase the likelihood of developing warts. […] Out of the 100 subtypes of HPV, a few of them have the propensity to induce cancer. […] Malignant transformation tends to occur in individuals with genital warts and those who are immunocompromised. […] Warts, in general, are benign, but there are reports that sometimes they may become malignant and develop into what is known as verrucous carcinoma. […] The verrucous carcinoma is a slow-growing tumor and is classified as a well-differentiated squamous cell malignancy that is often mistaken for a common wart. […] Malignant change is rare with common warts but rarely one may encounter transformation to verrucous carcinoma, which is most common on the plantar surface.

• #84 Nongenital Warts: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1133317-overview

  Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. […] Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.

• #85 Nongenital Warts: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1133317-overview

  Malignant change in nongenital warts is rare but has been reported and is termed verrucous carcinoma. […] Verrucous carcinoma is considered to be a slow-growing, locally invasive, well-differentiated squamous cell carcinoma that may be easily mistaken for a common wart. It can occur anywhere on the skin but is most common on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive.

• #86 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.7556%2Fjaoa.2018.024%2Fhtml&srsltid=AfmBOorU-bit4Mq3TixxKYYavYmOkfC45Io_WLYlodXJeAgS6aG6wERj

  The viral antigen is first taken up by Langerhans cells of the epidermis, which then enter the regional lymphatic drainage and thereby enter a lymph node. […] If this process fails, a persistent plantar wart is established. […] Plantar warts have a very high viral load, which increases the rate of viral shedding and the likelihood of contaminating adjacent body surfaces, inanimate communal surfaces, or close contacts. […] Plantar warts present a significant problem to athletes, as the pain can affect the athlete’s ability to ambulate. […] It is imperative that physicians consider that patients who present with large numbers of plantar warts or treatment-resistant plantar warts may have an underlying immunodeficiency and that patients with an established immunodeficiency and plantar warts may harbor a malignant neoplasm within the lesion. […] Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #87 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #88 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en

  After infection, if the virus is not cleared, the host basal keratinocyte is stimulated to divide and replicate viral DNA via HPV E1 and E2 proteins. […] The induction of cellular replication throughout the process of viral genome amplification leads to the hyperkeratinized papule that constitutes a plantar wart. […] Plantar warts tend to develop at areas of increased pressure on the sole of the foot, including the heel and metatarsal heads. […] As a result of normal sloughing of the epithelium, viral particles are released and may be transmitted to surfaces where the virus will lie until picked up by a new host or spread to adjacent sites (autoinoculation). […] In the most healthy persons, HPV infections are controlled by an immune response that begins on contact with the HPV particle.

• #89 Clinical Resolution of Plantar Warts Using the Needling Technique

  https://www.mdpi.com/2079-9721/13/2/50

  Plantar warts are common lesions found in clinical practice, produced by an HPV (Human Papilloma Virus) infection, particularly types that affect the skin, such as HPV-1, HPV-27, and HPV-57. […] The needling technique has been reviewed in the last few years, without meeting agreement yet on its effectiveness. Historically, since this technique was first documented in 1969, its effect has been suggested to rely on immunological mechanisms, activating an inflammatory response to the trauma. […] It can be assumed to be true, considering the fact that the natural course of an HPV infection downregulates the immune system through the expression of E5–E7 proteins and maintains a low copy number in the basal layer to evade immune detection. […] Since the infection naturally requires an immune response mediated by Langerhans cells and inflammatory cytokines, it is plausible that artificially damaging the lesional tissue with the needling technique could activate this response and contribute to viral clearance.

• #90 Immunotherapy with PPD in treatment of warts: An open labelled study from western Uttar Pradesh – IP Indian J Clin Exp Dermatol

  https://www.ijced.org/article-details/8428

  Warts are the viral infection of the skin caused by Human Papilloma virus, which manifest in the form of verrucous growth over the surface of skin. HPV is a DNA virus that infects skin or mucosal cells. It infects the basal layer of epithelium, possibly the stem cells, but viral replication takes place only in fully differentiated keratinocytes i.e. cells of the stratum spinosum and stratum granulosum. […] Currently, a newer form of therapy is in trend which is known as immunotherapy. This involves the amplification or activation of the patients immune system with the help of immunomodulators. Intralesional immunotherapy uses purified protein derivative, candida antigen, trychophytin skin test antigen. MMR vaccine, or Mw vaccine, to treat warts. […] In Intralesional immunotherapy, a delayed hypersensitivity response develops to the injected antigen and the wart tissue. It is usually seen that there is development of TH1 cytokines which activate cytotoxic and NK cells to eradicate the HPV infection.

• #91 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2018.024/html?lang=en&srsltid=AfmBOoqrid0VoPQb0x62k2u5jpxQjctB0uEdB0hNQ7gfu4hF_uLDhsjF

  If this process fails, a persistent plantar wart is established. […] Plantar wart management strategies are met with high degrees of variability in success rates and often fail to adequately manage a recalcitrant wart. Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #92 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management

  https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html?lang=en

  If this process fails, a persistent plantar wart is established. […] Plantar wart management strategies are met with high degrees of variability in success rates and often fail to adequately manage a recalcitrant wart. Because all currently available plantar wart management modalities address the lesion itself, none adequately manage the risk of transmission, which is intrinsic to the pathophysiologic mechanism by which the plantar wart develops and sheds viral particles.

• #93 Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management – Journal of Osteopathic Medicine

  https://jom.osteopathic.org/abstract/plantar-warts-epidemiology-pathophysiology-and-clinical-management/

  Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). […] Plantar warts shed HPV, which can then infect other sites in the plantar region or spread to other people. […] Given the high propensity for treatment resistance of plantar warts and no established, practical, and reliable method of prevention, HPV prophylaxis for populations that demonstrate high rates of plantar warts may be of benefit in controlling the spread of lesions.

• #94 Plantar Warts Background Information

  https://verrica.com/key_publications/plantar-warts-background-information/

  Verrucae plantaris (plantar warts) are common cutaneous lesions of the plantar aspect of the foot that are caused by the human papillomavirus (HPV). Ubiquitous in our environment, asymptomatic infection with HPV occurs frequently, with most infections controlled or cleared by cellular and humoral immune responses. […] Plantar warts shed HPV, which can then infect other sites in the plantar region or spread to other people. Although controlling risk factors is useful in preventing infection, the pervasive nature of HPV makes these preventive measures frequently impractical. This literature review outlines the current knowledge regarding the relationship between plantar wart pathophysiology, HPV transmission, and epidemiologic characteristics. […] Given the high propensity for treatment resistance of plantar warts and no established, practical, and reliable method of prevention, HPV prophylaxis for populations that demonstrate high rates of plantar warts may be of benefit in controlling the spread of lesions.

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