Is it a Wart or Something Else?

A patient complains of a "growth" that has been present for "quiet some time" and he thinks it is just a wart so has left it alone. Most recently it has caused pain and difficulty in walking and finally presented to me with a classic example of skin cancer. Although it rarely happens to the bottom of the feet, it has been documented. 

Warts are very common and easily treatable. They are thickened tissue and can be small & singular or be clustered to make a bigger one. But for the most part, it is uniform in color and tiny black dots can be seen. It is caused by the human papilloma virus (HPV), the same virus causing warts on other parts of the body. Skin cancer, on the other hand, is a different animal with different treatment plans.

What were the warning signs that the picture here was more than a wart?


1) "It just doesn't look right"

2) "It is huge"

3) "There are more than one color"

Anytime I get a funny feeling, I naturally think of the worse case scenario & think of two things: Could it be cancer? If so, how is it treated?

In this case, we decided to remove the entire lesion and send it to pathology. The results were confirmed as squamous cell carcinoma (SCC). At this point we referred the patient to our oncology colleague, who went for surgery again to see if it spread anywhere (using a radioactive dye) and fortunately it didn't. The margins left on the patient where the lesion was removed were clean as well as the lymph node biopsy. All that was left to do was monitor the patient and continue local wound care. *phew, right?*

Catching it sooner rather than later is always a benefit. If something doesn't look right to you, definitely have it checked out by a medical professional. Many conditions masquerade as something else and that is why I discourage anyone from self diagnosing and treating via the internet. 

You can read more about skin cancer at the much more eloquently written website by the American Cancer Society here: