Surgical indication for plantar warts is considered when persistent lesions are found.

To the extent that size and location allow, eradicating them in a timely manner is an advantage.

If a tangential section of a lesion is performed, it would become evident how thin the deep dermis would be after a fulguration or excisional shave.

The CO2 laser facilitates the subcutaneous dissection of the lesion, lodged in a bed of bleeding tissue with plantar fat, which must be preserved.

 

Tangential section of plantar wart

 

Any removal procedure would end up destroying the entire skin and thus cause a slower closure than with the benefit of primary suturing.

The central warty tissue resembles an onion. The lateral edges show no lesion.