The reason why children become "lazy" is...

Author: Luo Minqing, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Reviewer: Lusha, Chief Physician, Director of Skin Cosmetology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Xiao Ming, a primary school student, has become increasingly "lazy" recently. He complains about discomfort in his feet from time to time, especially when he is supposed to do exercises during recess or run in physical education class. Xiao Ming's father mistakenly thought that he was looking for an excuse to avoid exercise. Xiao Ming's feet were clearly not injured, but just felt a little rough, and he was pretending to be sick.

But as time went by, Xiao Ming's symptoms gradually worsened, and several soybean-sized bumps appeared on the soles of his feet, with black spots on them, which hurt when touched. At this time, his father realized that he might have wronged Xiao Ming, and hurriedly took him to the dermatology department for treatment. After a careful examination by the doctor, it was confirmed to be plantar warts.

So, what exactly is this plantar wart that bothers Xiao Ming? Let's learn more about it.

Plantar warts, as a type of hand and foot warts, are caused by human papillomavirus (HPV) infection and are contagious. They usually form rough papules on the soles of the feet, especially on the front of the palms and soles, and small black spots can be seen on the surface of some papules. Depending on the location of growth and clinical manifestations, human papillomavirus infection can also cause various types of warts, such as periungual warts, common warts, and flat warts. It is worth noting that most warts usually have no obvious symptoms, but warts located in pressure areas (such as the soles of the feet) will cause pain due to compression.

Figure 1 Copyright image, no permission to reprint

How to treat plantar warts?

1. Traditional treatment methods

Traditional treatments include surgery, cryotherapy, topical medications (such as salicylic acid, keratolytics, etc.), and local immunotherapy (such as local immunomodulators). However, these methods often have risks such as pain and trauma, and it is difficult to remove the virus deep in the skin, so there is a certain probability of recurrence.

2. New treatment methods

(1) Photodynamic therapy

Photodynamic therapy is a new treatment method that combines photosensitizers and laser light. The treatment process is usually as follows: first use laser to accurately vaporize part of the diseased tissue, then use packaging to fully combine the photosensitizer with the skin, and finally use laser of a specific wavelength to activate the photosensitizer, and use the effect produced by the photosensitizer after activation to kill viruses, bacteria and cancer cells. Compared with traditional treatment methods, photodynamic therapy can reach the deep layer of the lesion directly, and it not only has significant efficacy, but also has the advantages of low incidence of adverse reactions and low recurrence rate. At present, photodynamic therapy has been widely used in infections caused by HPV viruses such as genital warts, common warts, flat warts, as well as actinic keratosis, basal cell carcinoma and many other diseases.

Regarding the adverse reactions of photodynamic therapy, patients often worry about pain, edema and pigmentation. To relieve pain, patients can take oral analgesics before treatment, and the medical staff will adjust the laser energy density during the treatment to gradually build tolerance. Local edema and pigmentation in the treatment area are difficult to avoid. Edema usually subsides naturally within 24 to 48 hours after treatment. During this period, patients must take strict sun protection measures and strengthen local moisturizing and cleaning to promote skin recovery, reduce the occurrence of adverse reactions, and accelerate the improvement of skin dryness and pigmentation.

Figure 2 Copyright image, no permission to reprint

(2) Thermal therapy

Thermotherapy is a non-invasive method of treating viral warts by heating the local skin with far infrared rays. Its principle is to raise the temperature of the affected area to 40-46°C for a period of time, thereby selectively destroying the wart tissue. Diseased cells are more sensitive to temperature than normal cells, and will undergo apoptosis or necrosis after being heated, while normal cells can better withstand this temperature.

This treatment not only directly kills wart tissue through heat energy, but also stimulates the body's immune system. Localized heating causes immune cells in the skin (such as Langerhans cells) to migrate to deeper tissues, activating the systemic immune system and inducing an immune response to warts. This immune mechanism not only treats warts in the heated area, but also helps clear other untreated lesions.

During treatment, multiple courses of treatment are usually required. The number of treatments depends on the patient's specific situation, usually a "3+2+1+1" plan.

Thermal therapy has the advantages of less pain, non-invasiveness, high safety, no scarring, and suitable for larger warts. It is gradually becoming an emerging technology for the effective treatment of viral warts.

Although warts are common, they should not be ignored. Traditional treatments have certain limitations. New treatments such as photodynamic therapy can treat warts more effectively, reduce the risk of recurrence, and thus improve the patient's quality of life. If you have this problem, it is recommended to seek medical attention in time and choose the most appropriate treatment plan according to the doctor's advice.