Plantar warts? Or...?

[Tony Mobily]

Hi,

Timeline:

1st May: I noticed a huge callous in the ball of my left foot (left side). It was painful to walk on. I went to the doctor, who said it was a plantar wart and prescribed Sal Acid 70% in occlusion for 2 weeks

15th May: the whole callous part came right off. The pain stayed. I noticed that the pain extended towards the left a little. I waited a little

30th of May: The pain stayed and the foot still had a painful callous. I applied Sal acid for another week

3rd of June: The pain got worse, I poked the wart with a spliter needle. I noticed something that looked like small black splinters in the wart. I gave up after a bit of digging

7th June: Saw the doctor, who said that the Sal acid was probably applied for too long, and that the inflamation will probably go away

16th June: Pain is worse than ever. I filed some of the hard part off.

The ball of my foot now looks like this:

https://docs.google.com/file/d/0B-C98ZMLVO5VODdvR3ZSeEN0M3NDM2lxbFE1TWh0enhDWWxJ/edit?pli=1

The little dot on the left is the "original" problem, the one of the right is what really hurts. Note the small black twig-like black splinters in my foot.

I don't know if they are actually splinters. But, I am in a lot of pain.

Help?

[Bhupinder Kaur, MD]

Hello,

Thanks for posting your query.

I can understand your concern for the pain that you are suffering from due to the lesion on the sole of the foot. I have checked the photographs and from the symptoms and photograph it looks like a plantar wart which is caused by HPV.

It resembles a cauliflower, with tiny black petechiae (tiny hemorrhages under the skin) in the center and may be quite painful on application of pressure from either side of the lesion rather than direct pressure, unlike calluses which can be painful on application of direct pressure also.

The second possibility is of course of a callus but close physical examination can differentiate the two. One point is application of pressure and radiation of pain which i have mentioned above. Other differentiating point is that skin striae go around plantar warts but in case of callus or a benign tumor of the foot like a foot fibroma, the striations continue across the top layer of the skin.

You used the topical salicylic acid for 3 weeks in total and salicylic acid is the first line of treatment for plantar warts but it is used for 12 weeks. Now since the pain is persisting even after topical salicylic acid treatment you can consult a dermatologist and opt for other treatment methods. One of them is cryotherapy which uses the technique of freezing the internal cell structure of the warts, destroying the live tissue. Up to three sessions may be required. You can also opt for laser treatment but it is expensive and used for large, hard-to-cure warts.

Hope that this information helps and hope that you get better soon.

Wishing you good health.

[Tony Mobily]

Hi,

Never mind, please cut&paste this to see the photo:

https://docs.google.com/file/d/0B-C98ZMLVO5VODdvR3ZSeEN0M3NDM2lxbFE1TWh0enhDWWxJ

[Tony Mobily]

Hi,

This should be clickable: Photo

Merc.