Are You Mistaking Your Warts For Corns?

MEET ZARA

• 10 years old
• From Chinchilla
• Loves horse riding, sports, and music

We first met Zara and her dad when they came in for Zara’s painful ‘corns’ on her foot. Zara had previously been advised by her GP to apply a corn cream to her feet, which did not alleviate her pain. Zara was struggling to tolerate the pain that these ‘corns’ caused when she walked and stood. They had become very difficult to ignore when playing with her friends. Zara and her dad wanted the discomfort gone ASAP, so they came in to see our podiatry team for a second opinion.

Examination

On examination with our Podiatrist, there were actually four warts each with a 2mm diameter on Zara’s left foot, from the ball of her foot to her heel. While on the first inspection, we could see how they may have been mistaken for corns, no action had been taken to investigate and make a confident diagnosis. We confirmed they were warts because:

• We debrided the overlying callus and the exposed area was rough and cauliflower-like. If these were corn, we’d expect a smooth and consistent colour and texture of the skin that felt ‘hard’ when touched with a scalpel.
• On debridement, small black dots appeared, indicating the presence of small blood vessels to the area. This only occurs with warts as it is live tissue, as opposed to corns that are just areas of hard, dead skin with no blood supply.
• Zara showed more discomfort when the area was pinched, as opposed to pressing from above. This is a classic differentiating factor between warts and corns.
• Two of the four warts were present on non-weight-bearing or nonhigh-friction areas. Corns develop as a result of friction or pressure.

Warts (Verrucae)

A wart is an area of tissue that appears thickened, raised and is normally circular. They arise after contact with the Human Papilloma Virus (HPV), which is often contracted from communal areas that combine bare feet with damp surfaces, such as public swimming pools, gyms and saunas. Anyone can contract a wart, though it is more common in children.

CORNS

• Circular-usually regular
• Deeper even colour
• Smooth
• Skin striations move through the corn
• No small black dots / blood vessels
• Generally do not bleed
• Callus is often overlying

WARTS

• Circular-can be irregular
• Uneven/patchy/whiter colour
• Rough-cauliflower-like
• Skin striations move around the wart
• Black dots / blood vessels
• Often bleed (this is desirable)
• Callus is often overlying

Treatment

• The warts were debrided to remove as much of the wart tissue as possible, as this aids the efficacy of the treatment. 
• The warts were then frozen for 40 seconds each, silver nitrate was applied, and the area was sealed with a dressing.
• Zara was advised to use duofilm, containing salicylic acid, at home between visits to help treat the wart. Zara was to return in a fortnight for review and further treatment as needed. 

Results!

When Zara returned, she reported that she had no pain in her feet anymore and her dad confirmed that he hadn’t heard anything from Zara about the discomfort. The warts had a better appearance, but had not completely gone, so we repeated theprevious treatment.

It took approximately 7.5 weeks and 2 treatment sessions, before the third visit where we confirmed that Zara was now wart-free, pain-free and very happy!