Verrucae (warts) are the most common viral infections of the skin, affecting 7% to 10% of the general population. Typically caused by human papillomavirus type 1, plantar warts manifest as benign proliferation of the epithelial cells on the feet. It has been cited that up to one-third of nongenital warts become recalcitrant, and biopsy is often required to confirm diagnosis and direct appropriate treatment. These treatments can vary from various types of oral medications, acids, ablative modalities, and injections. In this article, we present a case of a recalcitrant plantar wart that appeared to circumferentially spread from the initial site after first-line treatment and presumed resolution with the product cantharidin. The development of ring warts is a known complication associated with cantharidin use, with little described rationale to the presentation.
Osteoid osteomas account for approximately 3% to 10% of primary bone tumors and are found most commonly in the cortical, diaphyseal regions of long tubular bones. These osteoblastic, benign tumors are usually seen in males, in the second to third decade, most often in the long bones of the lower extremity. The literature describes the limited encounters with osteoid osteomas of the pedal digital phalanx, especially in the pediatric population. Here, a case report details a juvenile patient with an osteoid osteoma tumor of the distal phalanx in the right second digit that was treated with complete distal phalanx excision in toto, eliminating the patient's pain and symptoms quickly after surgery. Further the literature is reviewed for other examples of this pathology in the similar clinical setting.