Spectrophotometric intracutaneous analysis findings and characteristics in plantar verruca

Verruca plantaris is the name given to the viral infection of human papilloma viruses (HPV), which is a DNA virus, on the soles of the feet. Although the diagnosis is usually made by clinical examination, it may be necessary to resort to other diagnostic methods as it can sometimes be confused with conditions such as callus or acral lentiginous melanoma. In addition to the distinction between malignant and bening lesions, dermoscopy, which is frequently used in the diagnosis of infections such as verruka plantaris, is one of the other diagnostic methods. However, dermoscopy has its own terminology, pattern analysis that requires subjective interpretation, experience for correct and effective use, and need for long-term training. SIAscopy, which is one of the multispectral examination methods, is a non-invasive examination method that provides images that give information about total and dermal melanin, collagen structure and vascular structure in addition to the dermoscopic color image. In this study, it was aimed to determine that the SIAscopic examination method in the verruca plantaris lesions contains features that may help diagnosis. For this purpose, the findings obtained in the dermoscopic color appearance method were compared with the findings of total melanin, dermal melanin, collagen and other SIAgraphs that provide information about the vascular structures, and it was aimed to reveal which SIAgraphic diagnostic features of the plantar warts have. The study was carried out on patients diagnosed with verruca plantaris who applied to polyclinic of Dermatology and Venerology of Ankara City Hospital between June and December 2019. A total of 25 patients, 16 female and 9 male, were included in the study. After the clinical history and examinations of the patients, the stage of taking SIAscopic images was started. At this stage, information about the history, age, sex, disease duration, anatomical location of the lesion on the foot, whether it was treated before and how many times HPV infection were recorded in the "Simsys" computer interface of the SIAscope. With the contact SIAscope device, SIAscope V, other 4 SIAgraphic images (total melanin, dermal melanin, collagen and blood views) taken automatically from the skin lesions of the patients in addition to the colored dermoscopic view were recorded on the computer. These SIAgraphs were examined one by one and compared with the dermoscopic literature information and findings. Colour views were recorded in terms of the findings and patterns encountered in previous studies with dermoscopes. Other SIAgraphic views were recorded in forms created separately for each patient as new and different findings. The data in the forms were transferred to MS Excel and IBM-SPSS programs and statistical calculations were made. Dermoscopic images are obtained in colour view in accordance with other literature, irregular limitation, dermatoglyphic loss, irregularly distributed red-brown-black spot hemorrhages, black red dots with white halo around, globules, linear hemorrhages with irregular distribution, yellowish papilliform surface and non-structured areas, filiform-like ledges were observed. Among the first findings found in verruca plantaris patients with a SIAscopic examination, white halo around the vein, wiping in keratinized areas and whitening in vascular areas in the view of total melanin were noted. There was no significant finding in the view of dermal melanin. There was a spotted collagen condensation, which was thought to be caused by dermal papillomatosis in the lesions of the wart lesions in the collagen view, and therefore due to the reflections of remitanal light due to the collagen structure in this area. There was a prominence in blood view in vascular structures that were noticed in colour. It was noted that vascular structures, which have not yet been thrombosed under the thickened epidermis, and therefore not detected in color appearance, appeared. Tracing the squams on the lesion as white areas in view of colour, collagen and blood constituted another of the siascopic findings. In this study, as a fast, non-invasive, easy-to-use examination method, just like dermoscopy, SIAscopy reveals that it can be used in the diagnosis of other skin diseases, especially the pathogenetic processes causing epidermal and papillary dermis changes, besides pigmented lesions. Key words: dermoscopy, HPV, SIAscopy, verruca plantaris