This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor:—
Please permit me to add to the already excellent answer given to the question on "Recurrent Plantar Warts" (201:1059, 1967).The four areas which blanch and are very tender are most probably porokeratotic. Recent studies done on well over 100 similar cases by Dr. Jacob Taub and myself show a relationship between these exquisitely sensitive lesions and underlying sweat gland hypertrophy. Clinically the lesion is pink and depressed somewhat centrally, and it is surrounded by a whitish areola. This white areola is histologically composed of compact parakeratotic epithelium. The bulbous central portion resembles a "coronoid lamella." Neither structure shows normal passage of glandular elements.The lesions occur under weight-bearing areas especially when a metatarsal head is depressed, or arthritic, or when a sesamoid bone is enlarged and displaced. These painful lesions or areas are discrete and not confluent as are verrucae. They may occur under any
Steinberg MD. Treatment of Plantar Warts. JAMA. 1967;202(6):551. doi:10.1001/jama.1967.03130190157038