Corns And Calluses

Corns and calluses - usually located on areas of repeated trauma (most often the feet) - are acquired skin conditions. A corn is marked by hyperkeratosis of the stratum corneum and is classified as soft or hard. A callus is an area of thickened skin, generally on the foot or hand. People whose activities produce repeated trauma (for example, manual laborers or guitarists) commonly develop calluses. The severity of a corn or callus depends on the degree and duration of trauma. The prognosis for both is good with proper hand or foot care.

Causes

A corn usually results from external pressure, such as that from ill-fitting shoes or, less commonly, from internal pressure, such as that caused by a protruding underlying bone (resulting from arthritis, for example). A callus is produced by external pressure or friction.

Symptoms

• Thick and hardened skin
• May be flaky and dry
• Located on hands, feet, or other areas that may be rubbed or pressured

Diagnostic tests

Corns can be recognized on sight. A family physician or podiatrist may scrape skin off what seems to be a callus, but may actually be a wart. If the lesion is a wart, it will bleed. A callus will not bleed, but will reveal another layer of dead skin.

Treatment

Surgical debridement may be performed, usually under a local anesthetic, to remove the nucleus of a corn. In intermittent debridement, keratolytics - usually 40% salicylic acid plasters - are applied to affected areas. Injections of corticosteroids beneath the corn may be necessary to relieve pain. However, the simplest and best treatment is essentially preventive­avoidance of trauma. Corns and calluses disappear after the source of trauma has been removed. Metatarsal pads may redistribute the weight-bearing areas of the foot; corn pads may prevent painful pressure.

Patients with persistent corns or calluses require referral to a podiatrist or dermatologist; those with corns or calluses caused by a bony malformation, as in arthritis, require an orthopedic consultation.

Prevention

Eliminating sources of friction or pressure should help you prevent corns and calluses from developing. These approaches may help:

• Wear shoes that give your toes plenty of room. If you can't wiggle your toes, your shoes are too tight. Have your shoe shop stretch your shoes at any point that rubs or pinches.
• Wear padded gloves when using hand tools. Or try padding your tool handles with cloth tape or covers.

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