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November 6, 1967

Treatment of Plantar Warts

JAMA. 1967;202(6):551. doi:10.1001/jama.1967.03130190157038

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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