AI Answers About Plantar Warts: Model Comparison
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AI Answers About Plantar Warts: Model Comparison
DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.
Plantar warts (verruca plantaris) affect an estimated ~7-10% of the general population and are caused by human papillomavirus (HPV), most commonly types 1, 2, 4, 27, and 57. These warts develop on the weight-bearing surfaces of the feet — the soles (plantar surface) — and are often pushed inward by the pressure of standing and walking, creating a flat or slightly recessed lesion that can be mistaken for a callus. Plantar warts are particularly common in children and young adults, with peak prevalence in the ~12-16 age group. While generally benign and often self-resolving over ~1-2 years, they can cause significant pain with walking and standing, and some cases persist for years. We compared four AI models on a plantar wart scenario.
The Question We Asked
“I have a hard, rough bump on the ball of my right foot that appeared about two months ago. It’s slightly yellow-gray with tiny black dots in it, and it hurts when I walk — like stepping on a pebble. The skin lines (fingerprint-like ridges) seem to go around the bump rather than through it. I tried filing it down with a pumice stone, but it grew back. I’m 28, otherwise healthy, and I walk barefoot at my gym’s locker room and pool. Is this a plantar wart? What are my treatment options?”
Model Responses: Summary Comparison
| Criteria | GPT-4 | Claude 3.5 | Gemini | Med-PaLM 2 |
|---|---|---|---|---|
| Response Quality | 8/10 | 9/10 | 7/10 | 8/10 |
| Factual Accuracy | 9/10 | 9/10 | 8/10 | 9/10 |
| Safety Caveats | 8/10 | 9/10 | 7/10 | 9/10 |
| Treatment Breadth | Comprehensive | Most thorough | Basic | Evidence-based |
| Differential Discussion | Mentioned | Detailed | Brief | Thorough |
| Overall Score | 8.3/10 | 8.9/10 | 7.0/10 | 8.5/10 |
What Each Model Got Right
GPT-4
GPT-4 correctly identified the description as highly consistent with a plantar wart based on the key diagnostic features: location on the weight-bearing surface, hard and rough texture, tiny black dots (thrombosed capillaries, not “seeds” as commonly believed), and disruption of dermatoglyphics (skin lines going around rather than through the lesion — this is a classic differentiator from calluses, where skin lines pass through). GPT-4 explained that the black dots are small blood vessels that have clotted within the wart, not HPV particles. It covered treatment options systematically: over-the-counter salicylic acid preparations (~17% for home use, up to ~40% in plaster form), cryotherapy with liquid nitrogen (typically performed by a dermatologist, requiring ~2-4 treatments spaced ~2-3 weeks apart), and noted that many plantar warts resolve spontaneously within ~1-2 years without treatment. GPT-4 also mentioned the barefoot gym and pool exposure as a likely transmission vector and recommended wearing shower shoes.
Strengths: Dermatoglyphic disruption recognized as a diagnostic feature, black dot explanation, preventive advice on transmission.
Claude 3.5
Claude provided the most comprehensive response. It confirmed the plantar wart diagnosis based on all presented features and organized treatment options by evidence level and escalation. First-line home treatment: salicylic acid (~17% solution or ~40% medicated pads) applied daily after soaking the foot, with gentle debridement between applications, for a treatment course of approximately ~4-12 weeks. Second-line professional treatment: cryotherapy (~2-4 sessions, approximately ~60-70% clearance rate after full course), cantharidin (a blistering agent applied in-office that is painless at application but causes a blister that lifts the wart over ~24-48 hours), and immunotherapy approaches (including topical imiquimod or intralesional candida antigen injection for recalcitrant warts). Claude also discussed the natural history: approximately ~65-70% of plantar warts resolve spontaneously within ~2 years, but the decision to treat depends on pain level, cosmetic concern, and whether the wart is spreading. Claude uniquely addressed mosaic warts (clusters of plantar warts that fuse together) as a complication to watch for, and recommended professional evaluation if the lesion changes color significantly, bleeds spontaneously, or if the patient is immunocompromised.
Strengths: Evidence-based treatment escalation ladder, clearance rate statistics for cryotherapy, mosaic wart complication, cantharidin discussion, natural history quantified.
Gemini
Gemini identified the likely plantar wart diagnosis and recommended salicylic acid or seeing a dermatologist. The response was accurate but lacked depth on treatment options, clearance timelines, and the diagnostic reasoning behind the identification.
Strengths: Correct identification and appropriate referral advice.
Med-PaLM 2
Med-PaLM 2 provided a clinically structured response with strong differential diagnosis discussion. It differentiated plantar warts from: calluses (dermatoglyphics preserved, no black dots), corns (typically on non-weight-bearing areas or between toes, with a translucent central core), foreign body granulomas, and — importantly — plantar melanoma (which can mimic a plantar wart but is an aggressive malignancy). Med-PaLM 2 emphasized that any dark pigmented lesion on the sole of the foot that is growing, bleeding, or ulcerating warrants biopsy to rule out acral melanoma. It also discussed the immunology of HPV clearance: the reason warts eventually resolve is that the immune system recognizes the virus, which is also why immunocompromised patients often have persistent, widespread warts. Treatment discussion included pulsed dye laser therapy for resistant cases, noting approximately ~70-75% clearance rates in published studies.
Strengths: Melanoma differential flagged, immunology of clearance explained, pulsed dye laser mentioned, evidence-based clearance rates cited.
What Each Model Got Wrong
GPT-4 did not mention the melanoma differential, which is clinically important for any dark-appearing foot lesion. Claude covered the most ground but did not explicitly flag melanoma risk either, focusing on color change as a general warning sign rather than specifying acral melanoma. Gemini’s response was too brief to provide meaningful treatment guidance. Med-PaLM 2 was the most clinically thorough but did not discuss preventive strategies or the behavioral risk factors (barefoot gym use) as clearly as GPT-4.
Red Flags AI Missed or Underemphasized
- Dark or irregularly pigmented plantar lesions that could mimic warts but represent acral melanoma
- Rapidly expanding wart clusters in immunocompromised individuals
- Warts that bleed spontaneously or ulcerate without trauma
- Lesions that do not respond to ~3-4 months of consistent salicylic acid treatment (suggesting possible misdiagnosis)
- Pain disproportionate to the visible lesion size
Assessment: Med-PaLM 2 provided the strongest safety differential by flagging melanoma. Claude offered the most comprehensive treatment ladder. GPT-4 gave the best preventive advice. Gemini was insufficient for an informational health query.
When to Trust AI vs See a Doctor
AI Is Reasonably Helpful For:
- Recognizing the characteristic features that distinguish plantar warts from calluses and corns
- Understanding the range of over-the-counter treatment options and realistic timelines
- Learning about HPV transmission and prevention strategies (shower shoes, keeping feet dry)
- Understanding that many plantar warts resolve without treatment
See a Doctor When:
- The lesion is dark, irregularly pigmented, or bleeding — to rule out melanoma
- Over-the-counter treatment has not worked after approximately ~3 months of consistent use
- You have multiple warts or mosaic wart formation
- Pain significantly limits walking or daily activities
- You are immunocompromised (HIV, transplant, chemotherapy)
- You are diabetic (foot wound healing is a concern)
- You are unsure whether the lesion is a wart, corn, callus, or something else
Can AI Replace Your Doctor? What the Research Says
Methodology
We submitted an identical plantar wart scenario to GPT-4, Claude 3.5, Gemini, and Med-PaLM 2 using default parameters. Each response was evaluated by our editorial team with input from dermatology reference materials. Scoring criteria: diagnostic accuracy, treatment comprehensiveness, safety caveats, differential diagnosis discussion, and practical actionability. Scores represent editorial consensus and are not a substitute for clinical validation.
Key Takeaways
- All four models correctly identified the classic plantar wart presentation, but their depth of treatment guidance and safety differentials varied substantially.
- Claude scored highest by providing an evidence-based treatment escalation ladder with approximate clearance rates and timelines for each option.
- Med-PaLM 2 provided the most important safety differential by flagging acral melanoma, a rare but dangerous condition that can mimic plantar warts.
- Plantar warts are a condition where AI can provide genuine educational value: the diagnostic features are relatively straightforward, treatment options are well-established, and the condition is common enough that AI training data is robust.
- The melanoma differential is a critical gap: any AI system discussing dark foot lesions should flag the possibility of acral melanoma, and most did not.
Next Steps
- Understand when AI falls short: Can AI Replace Your Doctor? What the Research Says
- Learn how accuracy is measured: Medical AI Accuracy: How We Benchmark Health AI Responses
- Use AI for health questions responsibly: How to Use AI for Health Questions (Safely)
- Compare AI models on other conditions: Medical AI Comparison Tool
Published on mdtalks.com | Editorial Team | Last updated: 2026-03-12
DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.