Verruca.

 

Definition:

A verruca (or plantar wart) is a wart that occurs on the sole of the foot. About one in ten in the UK have a verruca at any one time- they are contagious. They will usually go away by themselves (although this may take up to several years), but treatment can be used to resolve them more quickly if required.

 

 

Causes:

Veruccas are caused by the human papilloma virus, transmitted through close skin-to-skin contact. The virus gets into the skin through a cut or minor abrasion and causes the verruca. 

 

Patients are at higher risk if their skin is damaged, or if it is wet and macerated, and in contact with wet surfaces (for example, in swimming pools).

 

 

Presentation:

Verrucas are flattened, discrete lesions, usually on the ball of the foot, the underside of the

big toe or the heel. Multiple, black spots may be visible in the verucca (spots are due to

thrombolised blood vessels).

 

They can appear singly or in clusters, may be tender when squeezed and may cause

discomfort when walking. The discomfort is because the verruca occupies space within the

skin architecture, causing pressure and pain when walking.

 

 

Differential Diagnosis:

Ensure the condition does not itch or bleed, and isn't found anywhere else on the body.

 

Ask to see the verucca to positively identify it- if it is white and rubbery it may be a corn as

opposed to a verucca. Corns are non-infective and are commonly caused by ill fitting

footwear. It will not have thrombolised blood vessels and may appear on the top of the foot or between the toes.

 

All diabetic patients must be referred, and should be encouraged to have regular appointments with a chiropodist.

 

 

Treatment:

Salicylic acid, silver nitrate and lactic acid can destroy the skin (e.g. Bazuka Gel). Soften the

area with water- being sure to dry the skin well. Next, rub away any hard skin using an emery

board. Apply TWO drops of gel to the area DAILY, being sure to avoid healthy, normal skin.

 

Scholl verruca removal discs can also be used- a disc of appropriate size should be placed on

the area and the backing of the plaster should be removed and placed over the disc to hold in

place. The disc should be left in place for 48 hours.

 

Treatment may take up to 12 weeks to take effect. Patients should be made aware that the

pain caused by the verruca will intially get worse at the start of treatment before getting better. 

 

Other treatment which can be given OTC include products to freeze the verruca e.g. Wartie

Wart and Verruca Remover. Wartie rapidly freezes the verruca to the core in one treatment,

causing it to fall off after 10 to 14 days, revealing healthy new skin underneath.

 

 

Self Help Advice:

Wear a swim sock in the swimming pool.

 

Do not share towels.

 

Do not scratch warts, or bite nails or suck fingers which have warts to avoid spreading warts.

 

If you have a verruca change socks daily.

 

Sample Question:

What is the name of the virus which causes verrucas?

 

a) rotavirus

b) rhinovirus

c) human papilloma virus

d) coltivirus

e) baculovirus

 

Answers to all sample questions can be found by following the link under the Test Yourself tab.