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Plantar Warts: (Verruca Plantaris – Papillomas of the Sole)

- Discussion:
    - caused by a DNA virus of the Papovirus group;
    - characterized by localized lesions w/o central core and with sharp margins and high vascularity (vigorous punctate bleeding with shaving) 
           and pain with lateral compression;
    - three groups: solitary warts with surrounding callus
    - multiple warts with a large "mother" and tiny satellites;
    - mosaic patches of coalescent cores;

- Treatment Options:
    - observation: 1/2 resolve in one year, and upto 70% may resolve by 2 years;
    - salicylic acid plaster (+/- formalin) or bichloracetic/trichloroacetic acid preparations;
          - strategy is to reduce the mass of the wart (which relieves pain), and to then let the wart spontaneously resolve with time;
    - cryosurgery or liquid nitrogren application (small warts)
    - subdermal local anesthesia injections;
    - blunt dissection/curettage;
    - deep electrosurgery or excision should be avoided because of associated scarring;
    - avoid any treatment that produces scarring

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