I'm looking for info on "plantars" warts. What exactly are these? What causes them and can they be spread to others? How should I handle the situation if encountered on a pedicure client? Any info would be greatly appreciated Patricia 7/03Most people think that anything on the bottom of the foot that looks like a callus is a "wart". This is not true! Warts of the hands and feet are a fairly common nuisance that are estimated to affect 10% of the population. If this is a true statement then 90% of the time what is thought to be a wart, particularly on the bottom of the foot, is only a callus. By the end of this discussion you should be able to identify a wart versus a callus.
Common names for warts are papilloma and verruca. Warts are viral infections of the skin caused by a specific human papillomavirus (HPV). The virus multiplies within the nuclei of the cells that produce the skin. They cause papillary growth structures, which are elongated nipple like projections that are seen as the wart. A wart is one of the very few true tumors of the skin. It is not a cancer but is the result of the body trying to protect its self from the virus by forming a growth, or barrier, around the virus. Incuba-tion periods have ranged experimentally from 1 to 20 months. Viral particles invade the skin through direct introduction through the skin that may be caused by occupational in-juries, friction, nail biting and scratching. An open sore or cut that creates a "portal of entry" may also be the opening through the skin that allows the virus to produce the in-fection.
Since only about 10% of the population ever has a wart there is no rule which states that everyone exposed to the HPV virus will subsequently become infected. The long incubation periods and differences in resistance seen within individuals make it im-possible for clear-cut epidemiological patterns to be determined. Warts are rare in chil-dren under 5 and in the elderly. They are seen most commonly in the age groups between 5 to 20 years with the peak incidence being from 12 to 15 years of age. Warts however may occur at any age. From these statistics it appears that we are born with immunity to the virus. Some lose the immunity, 10%, and as they become infected the immunity is regained. This may explain why warts spontaneously regress in 30% of the infected peo-ple in 3 to 6 months and in 50% of the cases within 24 months. It is believed that this is because the body redevelops the antibodies against the HPV virus during the course of the infection. A few individuals never develop antibodies against the virus and these are the people who seem to have warts all their lives.
Warts may occur on any area of the body but seem to be found more commonly on the hands and feet. On the palmar surface of the hands and the plantar surfaces of the feet they appear as flat or slightly elevated circular callused areas which generally have small black dots or sliver like areas within them. (Quick word about "plantar" when re-ferring to the foot. Plantar does not mean the entire foot but only the "sole", bottom, or weight bearing surface of the foot.) These black dots or sliver like areas are really dried blood within a capillary that is located in the center of one of the papillary structures of the wart. They are not a sliver or foreign body as many infected individuals think when the wart first appears. By trying to remove the "sliver" they are really opening up the area for more infection. Warts on non-weight bearing surfaces appear as small-elevated cauliflower appearing lesions with the black dots, or dried areas of blood, seen at the tips of the easily visible papillary structures that make up the wart. A wart on the weight bearing surface of the foot, plantar aspect or sole, is harder to identify. This is because the pressure of walking on the wart flattens it out slightly but more importantly the wart is a foreign growth to the bottom of the foot. The skin in the area of the wart tries to pro-tect its self from this foreign body by building callus over and around the wart. This callus, the bodies' natural protection from added pressure or friction on the bottom of the foot, covers over the wart. The callus makes the wart appear totally different from the cauliflower look of a wart on a non-weight bearing area of the body. The callus may build up to such an extent that it totally hides the wart underlying it. This makes it very difficult to decide whether one is looking at a callus or a callus that is the result of a wart.
As a Nail Professional you should not be afraid to give a service to a client with a wart. The probability of the nail professional contracting the wart virus, based on statis-tics, is less than 10%. The probability is further reduced to near zero if the service does not cause the wart to bleed, and the Nail Professional does not have an open cut or sore on their hands. Using proper Sanitation/Disinfection procedures in the salon before and after client services also makes it nearly impossible for other clients to become infected after services have been provided to a client with a wart.
Dr. Oscar Mix