Differential Diagnosis for Chronic Plantar Wart with Sudden Onset of Pain
- Single most likely diagnosis:
- Plantar wart with increased pressure or irritation: This is the most likely diagnosis because the sudden onset of pain in a chronic plantar wart could be due to increased pressure on the wart, possibly from a change in footwear, activity level, or gait, causing irritation and discomfort.
- Other Likely diagnoses:
- Ingrown toenail: An ingrown toenail can cause significant pain in the toe area and might be mistaken for a painful plantar wart, especially if the wart is located near the nail bed.
- Corn or callus: A corn or callus can develop over a plantar wart, causing increased pressure and pain, or it might be a separate entity that has developed in response to friction or pressure.
- Plantar fasciitis: Although not directly related to the wart itself, plantar fasciitis can cause heel and bottom-of-the-foot pain, which might be confused with or contribute to the pain associated with a plantar wart.
- Do Not Miss diagnoses:
- Infection (cellulitis or abscess): An infection of the skin or soft tissue around the wart could cause sudden pain and should be treated promptly to avoid serious complications.
- Squamous cell carcinoma: Although rare, a long-standing plantar wart could potentially transform into squamous cell carcinoma, a type of skin cancer. Sudden changes in the appearance or sensation of the wart warrant further investigation.
- Rare diagnoses:
- Keratoacanthoma: A rare, rapidly growing tumor that can resemble a wart but has a different pathology. It typically resolves on its own but can be painful.
- Verrucous carcinoma: A rare type of low-grade malignancy that can present similarly to a plantar wart but is actually a form of squamous cell carcinoma. It is essential to consider this in the differential diagnosis of a long-standing, painful plantar wart.