Verruca pedis

What is it?

Verruca Pedis is a type of benign skin lesion arising from a viral infection of the epidermis. Verrucae are synonymous with ‘warts ‘and can occur on any area of skin, through they are most commonly found on the feet they can develop on overlying callosity which can make them painful. They are otherwise harmless lesion. Sam’s Foot Clinic

What causes it?

The virus responsible for verrucae is the Human Papilloma Virus. These are many strains of this virus, but the three most common for causing verrucae and warts are HPV1,2 and 4. Thankfully all these strains are the benlgn subtype though some cancers can resemble viral warts. As such, it is always important to have suspected verrucae investigated by a foot health professional.

HPV is ubiquitous. Strains causing verrucae and warts are found commonly on the hands of most people as well as many inanimate objects that we come into contact with each day. However, it is a weak virus as it is easily washed off of the outer layer of the epidermis as well as easily washed off of inanimate objects. The strains responsible for verrucae and warts only cause infection when they get access to the base layer of the epidermis. It is because the cells that they target for viral replication are metabolically active keratinocytes which are found at this base layer. As the epidermis provides a very robust barrier to most things, it takes a breach in the outer layers of the epidermis to allow the virus to access theses metabolically active keratinocytes to cause infection. Thus, if the skin is excessively wet or macerated or has been subject to micro tears, the risk of infection increases.

Once at the site, provided the individual does not have immunity to the infection the latent phase of the infection (i.e. incubation) is typically quite slow and is estimated to be anywhere between 6 weeks and 8 months. This is because the virus replication with the affected keratinocytes is slower and less directly cell-damaging relative to other viral infections. The process of virus replication produces proliferation of prickle cells which alters the character of the epidermis, resulting in the visible warty appearance of the verrucae. The nature of the slowed viral replication, the epidermis being out of reach of the majority of the body’s immune system and the ability of the virus to evade detection through localised cytokine suppression means that verrucae and warts can be persistent skin lesion that struggles to respond to a range of treatment options. The way in which the lesions will typically disappear is through ‘spontaneous resolution’ in other words the body eventually identifies its presence and mounts the necessary immune response. Sams Hair and Beauty

How do I treat verruca?

Often treatment is not indicated. In many instances the nature of the lesion needs to be carefully explained to the patient and/or parent/carer. On the back of that discussion, unless the verruca is painful or causing other considerable concerns, it is often left alone to allow the body to eradicate the infection in time.

However, instances where the verruca is proving problematic in either the form of pain or psychosocial distress, some treatment options may be considered.

Please do seek the advice of a foot health professional if you are concerned about verrucae

Sams Hair and Beauty foot clinic Westward Ho