HPV Types That Cause Plantar Warts
Plantar warts (Verruca plantaris) are primarily caused by HPV types 1,2,4,27, and 57, with HPV-1 and HPV-2 being the most common causative agents. 1
Predominant HPV Types in Plantar Warts
- HPV-57 is the most prevalent genotype (37.1%) detected in plantar warts according to recent research 2
- HPV-27 is the second most common type (23.8%) found in plantar warts 2
- HPV-1a accounts for approximately 20.9% of plantar wart cases 2
- HPV-2 is responsible for about 15.2% of plantar warts 2
- HPV-65 is less common, found in only about 2.8% of cases 2
Clinical Characteristics of Plantar Warts
- Plantar warts develop following infection of keratinocytes by HPV at the basal layer, resulting in epidermal thickening and hyperkeratinization 1
- The virus typically enters through small breaks or abrasions in the skin of the foot 3
- Diagnosis can be confirmed by paring down the wart, which often results in pinpoint bleeding as capillary loops of elongated dermal papillae are exposed 1
- Plantar warts need to be distinguished from corns, calluses, and other keratotic lesions through careful paring and inspection 1
Transmission and Risk Factors
- HPV can spread through direct contact or via the environment 1
- The virus may remain infectious outside the body for months or possibly years 1
- Self-inoculation can occur, leading to multiple warts in different areas of the foot 2
- Certain populations demonstrate higher rates of plantar warts compared to the general population 3
Treatment Considerations
- Many plantar warts resolve spontaneously, especially in children (half clear at 1 year, two-thirds by 2 years) 1
- In adults, plantar warts can be more persistent, sometimes lasting 5-10 years without treatment 1
- First-line treatment typically involves salicylic acid preparations, which promote exfoliation of epidermal cells 1
- Cryotherapy with liquid nitrogen is another common treatment option 1
- HPV typing may be helpful in predicting treatment outcomes, as HPV-positive warts have been shown to respond better to treatment than clinically similar HPV-negative lesions 4
Important Clinical Considerations
- Persistent or extensive plantar warts in adults may warrant consideration of underlying immune deficiency 1
- Treatment should be guided by patient preference, available resources, and the experience of the healthcare provider 1
- No single treatment is ideal for all patients or all warts, and many patients require a course of therapy rather than a single treatment 1
- Recalcitrant plantar warts may require more aggressive treatment approaches, particularly when caused by specific HPV types like HPV-27 5
Human papillomavirus infection of the feet is a common condition that often resolves spontaneously but can cause significant discomfort and may require intervention depending on the location, size, and number of lesions.