Diagnostic Performance of Dermoscopy and Clinical Visual Diagnosis for Plantar Warts

Abstract

Background: Plantar warts caused by the human papilloma virus (HPV) are one of the most frequent pathologies in podiatry. Diagnosis is usually limited to the clinical presentation of the lesion. Biopsy and polymerase chain reaction (PCR) are expensive and can be difficult to access. However, the dermatoscope is a noninvasive tool that covers the gap between microscopic and macroscopic diagnosis.

Objective: This study compares the effectiveness of diagnosis of plantar warts using a dermatoscope versus visual clinical signs.

Methods: The study evaluated 25 patients with suspected HPV plantar warts by visual or dermatoscopic signs. Upon clinical suspicion of HPV, a sample was taken for PCR analysis. A dermatoscopic image of the plantar wart was collected, and the characteristic clinical signs were evaluated, including the discontinuity of dermatoglyphs, hemorrhagic dots, reddish linear vessels, verruciform surface and frog-spawn appearance.

Results: All 25 patients showed positive results in molecular testing. Dermatoscopic findings compatible with HPV were obtained for 100% (25/25) of patients, while clinical signs were observed in 84% (21/25). The most common finding was the alteration of dermatoglyphs, which was present in all patients at the dermoscopic level. The sensitivity of the dermatoscope was 100% and identical to that of PCR.

Conclusion: The dermatoscope appears to be a useful, noninvasive and rapid tool for clinical use in the diagnosis of plantar warts.