Домой Бородавки Подошвенная бородавка

Подошвенная бородавка

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Подошвенная бородавка. Причины, лечение патологии


Подошвенные бородавки – это доброкачественные новообразования из эпителиальных клеток в виде небольших наростов, вызываемые вирусом папилломы человека. Локализуются данные проявления непосредственно на опорных участках стопы или пальцах ног.

Интересные факты:

  1. Согласно статистике, проявление подошвенных бородавок чаще всего наблюдается в возрасте от 20 до 30 лет.
  2. В большинстве случаев (более 50%) подошвенные бородавки могут проходить сами по себе, без какого-либо лечения.
  3. По разным данным носителями ВПЧ (вирус папилломы человека) являются от 70 до 90 процентов населения планеты.
  4. В народе подошвенные бородавки зовутся «шипицей». Ассоциируется данная интерпретация с шипами, на которые больно наступать.
  5. Большая часть всех типов ВПЧ поражают кожные покровы.

Причины бородавок

Бородавка — это вирусное заболевание кожи, которое вызывается вирусом папилломы человека.

Существует порядка ста разновидностей данного вируса. Они могут попасть в организм человека и длительное время никак себя не проявлять, благодаря таким защитным свойствам организма как:

  • иммунитет;
  • фагоцитоз (это неспецифическая защитная реакция организма, которая заключается в том, что при попадании патологического агента в организм фагоциты окружают его и уничтожают).

Риск заражения вирусом папилломы человека зависит от следующих факторов:

  • активность вируса у человека носителя;
  • характер контакта (прямой или непрямой контакт);
  • состояние иммунитета заразившегося человека.

70 – 90% людей являются носителями вируса папилломы человека, однако, возникнет бородавка или нет, зависит от состояния иммунитета. Люди, у которых сопротивляемость организма снижена, более подвержены проявлению бородавок. Также риск развития бородавок повышается в тех случаях, когда на организм действуют неблагоприятные факторы (например, стресс, утомление, бессонница, нарушение гигиены), которые ведут к ослаблению иммунитета.

Вирусом папилломы можно заразиться контактным путем с человеком, имеющим бородавки, например, через рукопожатие, предметы общего пользования (полотенце, домашние тапочки);

Существуют следующие предрасполагающие факторы для заражения вирусом папилломы человека:

  • потливость ног (кожа становится более рыхлой, и проникновение различной инфекции через нее облегчается);
  • частая стирка, уборка (частое раздражение кожи различными моющими средствами разрушает защитный барьер кожи и, тем самым, облегчает проникновение вируса)
  • микротравмы кожных покровов или слизистой оболочки (трещины, царапины, ссадины являются входными воротами для проникновения инфекции в организм);
  • дискомфортная тесная обувь, провоцирующая трение кожи стопы (мозоли, потертости также являются входными воротами для попадания инфекции в организм);
  • заболевания, которые ведут к нарушению питания эпителия стопы (например, сахарный диабет, атеросклероз);
  • заражение вирусом может произойти через инструменты для педикюра (в случае, если не была произведена дезинфекция приборов);
  • общественные бани, сауны или бассейны (места в которых происходит непосредственный контакт стоп с возможно зараженной поверхностью пола).

Кожа человека состоит из эпидермиса, дермы и подкожно-жировой клетчатки. Вирус папилломы человека, проникая в ткани кожи, поражает базальный слой эпидермиса. Впоследствии размножаясь, пораженные вирусом клетки поднимаются через все слои эпидермиса и локализуются на поверхностном роговом слое эпителия, проявляясь внешне грубой и ороговевшей кожей.

Вирус папилломы человека


ВПЧ — это инфекция из семейства паповавирусов, которая поражает слизистые оболочки органов (как правило, это половые органы), а также эпителиальные клетки кожи. В состав папилломавируса входит ДНК (дезоксирибонуклеиновая кислота), которая при внедрении в клетку человеческого организма провоцирует ее производить новые частицы вируса.

Все типы ВПЧ можно условно разделить на две группы:

  • папилломавирусы, имеющие онкогенные свойства;
  • папилломавирусы, не имеющие онкогенные свойства.

Примечание: онкогенные свойства способствуют образованию злокачественной опухоли.

На сегодняшний день существуют более ста типов вируса папилломы человека. Подошвенные бородавки, как правило, вызывает первый тип ВПЧ, в некоторых случаях их образование могут спровоцировать второй и четвертый типы (не онкогенные папилломавирусы).

ВПЧ обычно присутствует у каждого человека, живущего половой жизнью. Данным вирусом инфицированы каждые восемь из десяти человек. Из всех типов ВПЧ как самые опасные выделяют 6, 11, 16 и 18. Именно эти типы ВПЧ могут вызывать папилломы, кондиломы и рак.

Симптомы и как выглядят бородавки на стопе

Признак Проявление Фото
Блестящая поверхность Изначально подошвенная бородавка появляется в виде глянцевой бляшки, затем ее поверхность ороговевает, становясь шероховатой и более грубой.
Размеры Размеры подошвенных бородавок колеблются от одного до двух сантиметров и возвышаются над поверхностью эпителия на один – три миллиметра. Чаще всего бородавки овальной или круглой формы. Также существует понятие материнской и дочерней бородавки. Материнская бородавка появляется первой и является самой крупной, вокруг нее, как правило, могут образовываться дочерние бородавки меньших размеров. Со временем материнская и дочерние бородавки могут соединяться, образуя поражения больших размеров.
Болезненные ощущения Подошвенная бородавка находится на стопе, куда приходится большая часть веса. Бородавка сдавливается между подошвой и костями что приводит к уплотнению окружающих тканей. Такие бородавки, в большинстве случаев, очень болезненные из-за того, что бородавка может сдавливать нервы, находящиеся в стопе вызывая боль при ходьбе.
Цвет В большинстве случаев бородавки светло-коричневого или желто-белого цвета.
Черные точки Если с поверхности бородавки снять ороговевший слой, то на ложе пораженного участка могут наблюдаться темные точки, которые образуются по причине того, что кровоточащие капилляры в данной области тромбируются. Данный признак является отличительной особенностью подошвенной бородавки от мозолей и омозолелостей.

Удаление бородавок подошвы


В настоящее время существуют много эффективных и безопасных методов лечения подошвенных бородавок. Однако следует заметить, что в некоторых случаях надежное удаление бородавки усложняется тем, что вирус папилломы человека проникает в самые глубокие слои эпидермиса (в базальный слой).

Лечение бородавки необходимо в тех случаях если:

  • бородавка болит;
  • бородавка кровоточит;
  • бородавка больших размеров;
  • окраска бородавки неравномерная (например, в ней появились вкрапления);
  • наблюдается быстрая динамика роста бородавки.

Существуют следующие методы удаления подошвенных бородавок:

  • криодеструкция;
  • лазерная коагуляция;
  • электрокоагуляция;
  • радиоволновая хирургия;
  • хирургическое иссечение.

Криодеструкция

Данный метод заключается том, что на бородавку воздействуют с помощью жидкого азота с температурой минус 196 градусов. Криодеструкция характеризуется тем, что при замораживании бородавки происходит уничтожение пораженного вирусами участка кожи с последующей стимуляцией иммунных сил организма. Однако следует заметить, что если бородавка появилась и существует до шести месяцев, то эффективность ее удаления составляет 84%. В то время как результативность удаления бородавок, существующих более шести месяцев, сводится к 39%.

Процедура криодеструкции может выполняться:

  • обычно (жидкий азот наносится до появления вокруг бородавки светлого ореола диаметром два миллиметра);
  • агрессивно (после появления вокруг бородавки светлого ореола жидкий азот продолжает наноситься еще в течение пяти – двадцати секунд).

Исследования показали, что агрессивный метод замораживания бородавки является более эффективным, нежели обычный способ, однако его недостатком является то, что он является более болезненным.

После удаления бородавки на месте воздействия наблюдается гиперемия (покраснение) кожи с последующим образованием отека. Через несколько часов на пораженном участке образуется пузырь (может содержать геморрагическую или серозную жидкость), а примерно через шесть – семь дней после высыхания пузыря на его месте образуется корочка, которая отпадает самостоятельно в течение двух недель.

После удаления бородавки следует соблюдать следующие рекомендации:

  • образованный пузырь на месте бородавки не следует вскрывать;
  • пораженный участок не следует заклеивать лейкопластырем;
  • место воздействия рекомендуется свободно, не стягивая, забинтовать стерильным бинтом, чтобы предотвратить механическое повреждение и загрязнение пораженного участка;
  • два раза в день рекомендуется обрабатывать пораженный участок салициловым спиртом 2%;
  • стараться избегать попадания воды на место воздействия.

Преимущества метода Недостатки метода
заживление тканей происходит без образования рубцов в случае если воздействие жидким азотом происходит поверхностно, то существует высокая вероятность рецидива (повторного образования) бородавки
процедура производится без применения местной анестезии после процедуры может наблюдаться местная гипо- или гиперпигментация
удаление бородавки с помощью данного метода занимает от одной до двух минут если происходит более глубокое прижигание, имеется риск образования рубцов

Лазерная коагуляция

Удаление бородавок с помощью лазерного луча на сегодняшний день является одним из самых распространенных методов лечения. Данный метод характеризуется послойным прижиганием пораженного участка, что позволяет контролировать глубину воздействия. Также при удалении бородавки лазерный луч одновременно припаивает сосуды, предотвращая тем самым развитие кровотечения в месте воздействия.

Существуют следующие методы лазерной коагуляции:

  • Углекислотный (CO2) – лазер. Воздействие на бородавку производится с помощью инфракрасного света (длина волны составляет 10 600 нм). Недостатком данного метода лечения является то, что прижигание тканей происходит не избирательно, то есть существует вероятность повреждения здоровых тканей. Эффективность удаления подошвенных бородавок с помощью углекислотного лазера составляет 70%.
  • Эрбиевый лазер. Данный метод характеризуется более короткой волной, длина которой составляет 2940 нм, что значительно снижает вероятность образования рубцов после эпителизации тканей. Эффективность данного метода лечения составляет 75%.
  • Импульсный лазер на красителях. Данный метод характеризуется выборочным поглощением энергии (длина волны составляет 586 нм) оксигенированным гемоглобином, при котором первостепенно происходит разрушение расширенных капилляров в бородавке, а также стимуляция иммунитета, что способствует эффективному излечению. Результативность данного метода лечения составляет примерно 95%.

После лазерного лечения на пораженном участке образуется корочка, которая самостоятельно отпадает в течение семи – десяти дней. Корочку не рекомендуется срывать, а также смазывать чем-либо (мази, крема, спиртовые растворы). Также в первые несколько дней после процедуры следует избегать попадания воды на место воздействия.

Преимущества метода Недостатки метода
заживление тканей происходит без образования рубцов к недостаткам данного метода можно отнести лишь высокую стоимость процедуры
быстрое заживление тканей
низкий риск рецидива (повторение заболевания)
практически не затрагивает здоровые ткани

Электрокоагуляция

На подошвенную бородавку воздействуют током высокой частоты. Прижигание пораженного участка должно производиться под местным обезболиванием. Благодаря коагуляционной петле, наложенной на пораженный участок кожи, происходит воздействие электрическим током на бородавку, что ведет к ее гибели. Также действие высоких температур ведет к припаиванию сосудов, что предотвращает развитие кровотечений.

После проведения процедуры на месте воздействия образуется плотная корочка, которая самостоятельно отпадает в течение десяти дней.

После удаления бородавки следует соблюдать следующие рекомендации:

  • в период заживления стараться избегать попадания воды или мыльных средств на пораженный участок кожи;
  • образованную корочку не следует трогать или срывать;
  • в первые семь – десять дней место воздействия рекомендуется обрабатывать антисептическим средством (например, раствор Люголя, Йодинол) один – два раза в день.

Преимущества метода Недостатки метода
доступная стоимость процедуры применяется при неглубоких бородавках небольших размеров
предотвращает развитие кровотечения при воздействии на глубокие слои кожи после заживления тканей может остаться шрам
процедура занимает от нескольких секунд до одной минуты при поверхностном удалении бородавки возможен ее рецидив

Радиоволновая хирургия

Данный метод лечения заключается в использовании специального электрода, излучающего радиоволны высокой частоты (3,8 – 4,0 МГц). Воздействие высоких температур на подошвенную бородавку вызывает испарение клеток, пораженных вирусом папилломы. Также, благодаря прижиганию сосудов, использование данного метода предотвращает развитие кровотечения. После воздействия на пораженном участке кожи образуется корочка, которая самостоятельно отпадает в течение семи – десяти дней.

В период заживления противопоказано:

  • в первые два дня после процедуры не следует мочить место прижигания;
  • срывать корочку в течение семи – десяти дней.

Преимущества метода Недостатки метода
при воздействии на пораженный участок, здоровые ткани практически не затрагиваются высокая стоимость процедуры
после заживления тканей существует минимальный риск образования рубцов
после лечения низкий риск ремиссии (два – пять процентов)

Хирургическое иссечение

Данный метод характеризуется удалением бородавки с помощью скальпеля под местным обезболиванием. После иссечения пораженного участка накладываются швы, которые снимаются через семь – десять дней.

Преимущества метода Недостатки метода
применяется для удаления бородавок больших размеров после снятия швов на пораженном участке могут остаться шрамы
существует риск ремиссии (изчезновения симптомов) бородавки

Общие принципы ухода за пораженным участком кожи после удаления бородавки:

  • в случае образования корочки ее нельзя трогать или срывать;
  • ограничить попадание воды на пораженное место;
  • после удаления бородавки нельзя, чтобы место воздействия находилось под прямыми солнечными лучами;
  • на пораженный участок кожи не следует наносить какие-либо косметические средства (например, крем или лосьон);
  • в течение одного – двух месяцев после удаления бородавки не рекомендуется посещать общественные сауны, бани или бассейны;
  • после удаления бородавки рекомендуется применять витамины A, C и E, так как они способствуют быстрой регенерации (заживлению) тканей, а также стимулируют защитные силы организма.

Примечание: В случае, если после удаления бородавки возникли осложнения (воспаление пораженного участка, длительное заживление, образование рубцов), необходимо как можно скорей обратиться к лечащему врачу.

Для всех методов лечения противопоказаниями к проведению процедуры являются:

  • сахарный диабет;
  • наличие злокачественных опухолей;
  • беременность;
  • инфекционно-воспалительные заболевания возле бородавки;
  • обострение герпеса;
  • повышенная температура тела;
  • повышенное артериальное давление (выше 140 на 100 миллиметров ртутного столба).

Лечение бородавок без операции

Название мази Механизм лечебного действия Как использовать
Салициловая мазь Оказывает антисептический и противовоспалительный эффект. Обладает кератолическим (отшелушивающим) действием, которое за счет размягчения, растворения и отторжения поверхностного слоя эпидермиса способствует быстрому обновлению кожи. Для лечения бородавок используется салициловая мазь 60%. Перед использованием препарата рекомендуется распарить ноги, а затем тщательно их осушить. После этого на подошвенную бородавку следует нанести мазь тонким слоем, а затем забинтовать обработанный участок. Повторять процедуру необходимо через день до полного исчезновения бородавок.
Оксолиновая мазь Обладает ярко выраженным противовирусным действием. Для лечения подошвенных бородавок используется трехпроцентная оксолиновая мазь. Препарат наносится на пораженные участки кожи, после чего на обработанное место накладывается вощеная (покрытая тонким слоем воска) бумага. Повторять процедуру следует два – три раза в день. Курс лечения составляет два – три месяца.
Виферон Содержит витамин E. Оказывает противовоспалительное и иммуномодулирующее действие. Обладает антиоксидантными свойствами (вещество замедляющее окисление), а также усиливает регенерацию (обновление) клеток. Мазь наносится три – четыре раза в день в течение пяти – семи дней.
Риодоксол Обладает широким противовирусным и противогрибковым действием. Перед использованием препарата поврежденную кожу необходимо распарить и тщательно осушить. Затем на подошвенные бородавки следует нанести тонкий слой мази. Процедуру необходимо проводить один – три раза в день до полного исчезновения бородавок.
Примечание: в случае возникновения побочных эффектов (например, покраснение, зуд, жжение) следует смыть препарат теплой водой и в ближайшее время обратиться к врачу.

При единичных и неглубоких подошвенных бородавках рекомендуется применять народные методы лечения.

Наименование используемого средства Приготовление Применение
Уксусная кислота Необходимо приобрести уксусную кислоту 70%, вазелин, а также подготовить пипетку для нанесения точной дозировки. Перед применением уксусной кислоты необходимо обмазать здоровую кожу вокруг бородавки вазелином.
Затем с помощью пипетки следует нанести на бородавку одну каплю уксусной кислоты. Использовать данный метод следует раз в день до тех пор, пока бородавка не сойдет.
Чесночный настой Необходимо измельчить три зубчика чеснока, а затем залить полученную массу кипятком (50 мл). Спустя один час полученный настой необходимо процедить и использовать. Смазывать область бородавки следует полученным настоем один раз в сутки до полного исчезновения образования.
Соляной раствор Необходимо в теплой воде (100 мл) растворить одну столовую ложку соли и добавить одну столовую ложку столового уксуса (9%). Полученный раствор необходимо тщательно размешать, а затем опустить в него мякоть одной сливы и настаивать в течение двух часов. По истечении времени необходимо вынуть сливу из раствора и измельчить ее в кашицу.

Полученную сливовую кашицу необходимо наложить на бородавку.
Для надежной фиксации следует обмотать стопу и надеть на нее носок.
Данный компресс необходимо оставить на два – три часа. Процедуру следует повторять каждый день до полного исчезновения бородавки.
Настой полыни Необходимо в стакан горячей воды (250 мл) добавить три столовых ложки сухой полыни, накрыть крышкой и настаивать в течение двух часов.

Полученным раствором необходимо смазывать пораженные участки стопы три – четыре раза в день до тех пор, пока бородавки не сойдут.
Настой из лимонной кожуры Необходимо снять с двух лимонов кожуру и в измельченном виде поместить ее в литровую банку. Затем в сосуд следует добавить 100 мл столового уксуса 9% и закрыть банку плотной крышкой. Содержимое следует настаивать в течение одной недели, периодически встряхивая банку. По истечении срока настой необходимо процедить. Полученным настоем необходимо смачивать бородавки два раза в день до их полного исчезновения.
Отвар зверобоя На один стакан воды (250 мл) необходимо добавить одну столовую ложку измельченного зверобоя и прокипятить в течение 15-ти минут на медленном огне. После варки отвар необходимо охладить, а затем процедить. Полученным отваром необходимо смазывать бородавки три – четыре раза в день до их полного исчезновения.
Примечание: в случае проявления каких-либо побочных эффектов необходимо срочно обратиться к лечащему врачу.

В настоящее время в лечение подошвенных бородавок также эффективно применяется чистотел. Данное растение обладает лечебным соком желто-оранжевого цвета.

Чистотел обладает следующими лечебными свойствами:

  • бактерицидное (вызывает гибель потаенных микроорганизмов);
  • противовоспалительное;
  • спазмолитическое;
  • желчегонное;
  • противовирусное;
  • ранозаживляющее;
  • прижигающее;
  • противозудное;
  • также чистотел содержит в своем составе витамины A и C.

При лечении подошвенных бородавок используется свежий сок чистотела, которым необходимо натирать пораженные участки кожи два – три раза в день до полного исчезновения бородавок. Перед нанесением чистотела рекомендуется тщательно распарить ноги в горячей воде и пемзой удалить ороговевшую часть бородавки.

При лечении подошвенных бородавок чистотел оказывает следующие лечебные эффекты:

  • способствует снижению болевых ощущений во время ходьбы;
  • ускоряет процесс высушивания бородавки и образования корочки;
  • за счет содержания в своем составе витаминов A и C стимулирует местные иммунные реакции.

Также в состав чистотела входят различные кислоты (аскорбиновая, янтарная, яблочная, лимонная), к которым чувствителен ВПЧ.

Для повышения эффективности лечения подошвенных бородавок следует соблюдать следующие рекомендации:

  • ежедневно проводить гигиенические процедуры ног;
  • для укрепления иммунитета следует регулярно применять витамины (например, витамины A, E, C);
  • пользоваться индивидуальной обувью (например, домашние тапочки);
  • при сухости кожи ног необходимо регулярно пользоваться увлажняющими и питательными кремами для ног;
  • в общественных местах (баня, сауна или бассейн) необходимо использовать персональные тапочки и избегать хождения босиком;
  • тщательно выбирать подходящую обувь (например, соответствующий размер, натуральные материалы);
  • при повышенной потливости ног необходимо использовать подсушивающие средства (например, Уротропин, Формагель), а также стараться подбирать обувь в соответствии с погодой.

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