→Human papillomavirus can survive months to years on surfaces.21,24,25 Infection of a host requires direct contact with viral particles, which can occur through either direct contact via a plantar wart or indirect contact via fomites, such as flooring, socks, shoes, towels, and sports equipment.4,23 There is no systemic dissemination or viremic phase to HPV infection. As such, contact with body fluids, except those directly from the plantar wart itself, does not transmit HPV.14,21 Preexistent microtrauma of the epidermal barrier of the plantar aspect of the foot allows entry of the virus on contact.5,26-29 Once in contact with a host, HPV gains entry to the basal epithelial layer, where actively dividing stem cells are located.29,30 In the basal epithelium, the virus binds with cellular receptors and is subsequently taken up by the now-infected cell.8,31 After an incubation period of 1 to 20 months, viral DNA is then established within the host cell, usually without integration into the host cell genome.24,29,30
