Pathophysiology of Plantar Warts
Human papillomavirus can survive months to years on the infected surface. It can cause infection after direct contact with the virus. It can be occurred through direct contact with a plantar wart of the infected person or indirectly through the personal products such as socks, shoes, and towels of the infected person. Damage to the epidermal surface of the plantar surface may cause the infection. After entering the epidermal layer of the foot, the virus penetrates the basal epithelium, and it binds with the cellular receptors and starts the disease.
Viral DNA is established after 1-2 months of incubation in the host cell. After infection, the resultant immunity to the infection may cause clearness of the infection or latent infection. If the virus is not removed from the infected cells, the basal keratinocytes stimulate and divide the DNA of the virus with the help of HPV E1 and HPV E2 protein. Basal stem cells contain 20-100 copies of viral DNA but few viral proteins.
After the differentiation of basal cells into keratinocytes, they start progressing towards the epithelium. There is increased production of viral proteins as the viral genome promoter region is activated. The viral DNA is packed into the protein capsules. The viral DNA can be released from the infected desquamated keratinocytes on the surface to infect nearby tissue. Due to amplification of the viral genome, it leads to hyperkeratinization of the keratinocytes and formation of hyper keratinized papules that are the typical plantar warts.
