Viral Infections of the Feet

Hand, Foot, and Mouth Disease

This viral infection is caused by the Coxsackie A16 enterovirus. This means the virus is found in the gut and subsequent fecal matter. Pediatric patients are the most frequent population to attain this infection. Skin lesions that look like gray, oval shaped, vesicles surrounded by a red halo can be seen on the sides of the fingers and bottom of the feet. Painful oral lesions may also occur during the infectious period. To prevent this infection one should frequently wash their hands. The infection is self limited and typically resolves in one week. Low grade fever and sore throat may occur during the week of the infection.

Herpes Zoster

Varicella-zoster virus also known as chicken pox is highly contagious and can be transferred easily when in contact with open lesions. There is an incubation period of up to two weeks and then a rash will begin at the hairline, and will move to the skin. The papules will become fluid filled and can burst and leak. The hands and the feet can become symptomatic with lesions.

The lesions are itchy and the patient should avoid scratching them. Topical creams such as calamine lotion can be applied to decrease the itch. The condition is self limiting and will self resolve with time.

Molluscum Contragiosum

A three millimeter umbilicate pink, white, or flesh colored papule can appear on the genitals, lower abdomen, buttocks, and thighs. This infection is secondary to a DNA poxvirus and can be seen in children. Direct contact with the lesions can transmit the infection. The infection is self limiting and they resolve with a variable time period. They can be removed by curettage, cryotherapy, and the application of beetle juice (strong acid).

Plantar Verruca

Human papilloma virus (HPV) is the causative agent of warts. Thirty percent of cases resolve spontaneously but most require other treatment. They appear as callused lesions on the feet with black specs within the lesion. The skin lines diverge around the wart and there may be pain with side compression of the lesion. Sometimes the lesions can spread and multiply. This is called a mosaic wart. Treatments include, chemical destruction with acids, cauterization with electricity or laser, curettage, excision, and cyrotherapy. The treatment does not target the virus but rather damages the tissue so that the body attempts to fight against the virus itself. Some wart infections can be very difficult to treat.

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