Do podiatrists treat warts without dermoscopy?

Sometimes patients refuse to excise their warts and opt for chemical treatment. Dermoscopy can provide information about the halo surrounding blood vessels. I thought it would make sense that if the white halo present surrounding the hairpin shaped vessels in seborrheic keratosis, then similarly in a wart that same white color would be present in any halo surrounding vessels.

I believe this pinkish or reddened color could also be due to trauma. If one is faced with the possibility of trauma or malignancy, perhaps it is better to be cautious and to biopsy the area. It might be helpful if the following information is sent with the biopsy specimen to a dermatopathologist:

1. any history of trauma to the lesion,

2. any history of skin cancer,

3. any family history of skin cancer

4. a dermatocopic image of non contact polarized dermocopy and non polarized dermoscopy. The non polarized dermoscopy might show  a blue white veil, any milea cysts. The non contact polarized dermoscopy would best emphasize the vascular structures and the color of any surrounding halo as well as the shape and distribution of vascular structures. If the dermatopathologist is not familiar with dermoscopy perhaps the laboratory might have the availability of a consultant that is.

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