Corns and Calluses Distinguishing Between Corns and Calluses Treatment of Corns and Calluses When to

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Corns and CallusesDistinguishing Between
Corns and Calluses Treatment of Corns and
Calluses When to Refer
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• CORNS
• Small, raised, sharply demarcated, hyperkeratotic
  lesions having a central core
  
• May be yellow-gray, few mm to a few cm in
  diameter
  
• Base is on skin surface, apex points inward,
  presses on nerve endings and causes pain
  
• Usually painful
• Types
• Hard usually on surface of toes, shiny and
  polished
  
• Soft usually between 4th and 5th toe
  (perspiration macerates the epidermis and gives
  soft appearance)
  
• Cause Pressure from inappropriate, tight fitting
  shoes
  
• Location non-weight-bearing prominences or
  joints, such as metatarsal heads, the bulb of the
  great toe, the dorsum of the 5th toe, tips of
  middle toes

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CALLUSES

• Broad based or has a central core with sharply
  circumscribed margins and diffuse thickening of
  skin
  
• Have indefinite borders, may range from a few mm
  to a few cm in diameter
  
• Usually raised and yellow with normal patterns of
  skin ridges on surface
  
• Usually asymptomatic, pain only when pressure is
  applied
  
• Cause friction (loose-fitting shoes), walking
  barefoot, improper weight distribution
  
• Location joints and weight bearing areas such as
  the palms of hands, sides and soles of feet.

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TREATMENT

• Most important--ELIMINATE CAUSE (pressure and
  friction) by wearing comfortable, well-fitting
  shoes
  
• Nonpharmacologic Therapy
• Soaking ( 5 minutes, using warm water. Remove
  dead tissue with pumice stone or callus file). NO
  sharp knives or razor blades!
  
• Dr. Scholl pads
• Cushlin
• Orthotics ( arch supports for more serious foot
  deformities)
  
• These provide RELIEF, but usually dont CURE
  corns or calluses
  

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Pharmacologic TherapySalicylic Acid

• Collodion-like Vehicles
• Form an adherent flexible or rigid film and
  prevent moisture evaporation (sustained, local
  action of the drug)
  
• Contain 12-17.6 S.A.
• Plaster Vehicles
• Uniform solid or semisolid adhesive mixture of
  S.A. in a suitable base, spread on a backing
  material (felt, cotton, plastic) which is applied
  directly to affected area
• Contain 40 S.A.
• Include pads and discs of various sizes for
  direct application to the skin
  
• Provide direct and prolonged contact of the drug
  with the affected area
  
• See table 39.2 for specific products

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Guidelines for Treating Corns and Calluses with
S.A. Products

• Collodion-Like Products
• Wash and dry thoroughly the affected area
• Apply product once or twice daily directly to
  corn or callus
  
• Allow product to dry
• For hard corns and calluses, apply solution for
  up to 14 days or, if earlier, until corn or
  callus is removed
  
• For soft calluses, apply solution for 3-6 days
• Soak the affected foot in warm water, remove the
  soft, white skin with pumice stone
  

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Plaster Pads and Discs

• Wash and dry affected area
• Cut plaster to (or choose disc of) appropriate
  size, apply to corn or callus and cover with
  occlusive tape or pad
  
• Remove the plaster/pad every 24 hours
• After removal of plaster/pad soak the foot in
  warm water and remove the macerated skin
  
• Reapply plaster/pad after removing the softened
  skin
  
• Apply a maximum of 5 treatments over a two-week
  period
  

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When to Refer

• Self-medication yields no results after 2 weeks
• Patients with diabetes mellitus, peripheral
  circulatory disease (poor circulation)
  
• Patients with rheumatoid arthritis and complains
  of painful metatarsal heads and deviations of the
  great toe
  
• The lesions are oozing purulent material
• Corns and calluses indicate anatomic defect or
  fault in body weight distribution
  
• Patient has physical or mental impairments that
  make applying the treatment difficult