Persistent Plantar Lesion Following Medical Pedicure: Corn vs. Wart Differential Diagnosis

Case at a Glance

A 23-year-old female presents with a persistent plantar foot lesion that has failed to heal one month after debridement by a medical pedicurist, raising concerns about misdiagnosis between corn and plantar wart.

Patient's Story

The patient, a 23-year-old female (height 165 cm, weight 56 kg), initially presented to a medical pedicurist with what appeared to be a corn on her foot. The lesion presented as a hard, white, dot-like formation. Prior to the pedicure appointment, she had attempted self-treatment with corn removal bandages for approximately one month and daily foot soaks with diluted white vinegar solution. During the medical pedicure, the practitioner performed debridement of the lesion, which resulted in significant bleeding that persisted for an extended period. One month post-procedure, the lesion remains unhealed, leading the patient to suspect it may actually be a plantar wart rather than a corn.

Initial Assessment

Initially diagnosed as a corn based on appearance (hard, white, central dot formation). The lesion was located on the plantar surface of the foot. Patient had attempted conservative treatment with over-the-counter corn removal products and vinegar soaks prior to seeking professional treatment.

The Diagnostic Journey

The differential diagnosis between corn and plantar wart became complicated when the lesion failed to heal after debridement. Key distinguishing factors under consideration include: bleeding pattern (extensive bleeding may suggest vascular supply typical of warts), healing response (corns typically resolve after proper debridement), and morphological changes over time (presence of dead skin around the lesion post-treatment).

Final Diagnosis

Suspected plantar wart (verruca plantaris) based on failure to heal post-debridement, excessive bleeding during treatment, and persistent appearance with surrounding dead tissue.

Treatment Plan

Patient requires dermatological evaluation for definitive diagnosis and appropriate treatment. Treatment options for plantar warts may include cryotherapy, topical treatments, or other specialized interventions. Patient education regarding avoiding manipulation of the lesion to prevent spread or secondary infection.

Outcome and Follow-up

Patient concerns include potential scarring or permanent indentation at the treatment site. Dermatology referral recommended for proper diagnosis confirmation and evidence-based treatment approach. Patient advised to discontinue self-manipulation of the lesion and seek specialist care rather than attempting further self-treatment.