Callus, corn and wart Flashcards
Diagnosis
of localised, tender lumps on the sole of the foot can be difficult.
Comparison of the main causes of a lump on the sole of the foot
Callus
Typical site:
where skin is normally thick; beneath heads of metatarsals, heels, inframedial side of great toe
Nature:
hard, thickened skin
Effect of paring:
normal skin (as per diagram)
Comparison of the main causes of a lump on the sole of the foot
Corn
Typical site:
where skin is normally thin; on soles, fifth toe, dorsal projections of hammer toes
Nature:
white, conical mass of keratin flattened by pressure
Effect of paring:
exposes white, avascular corn with concave surface
Comparison of the main causes of a lump on the sole of the foot
Wart
Typical site:
anywhere, mainly over metatarsal heads, base of toes and heels; has bleeding points
Nature:
viral infection, with abrupt change from skin at edge
Effect of paring:
exposes bleeding point
Calluses
Remove the cause.
Proper footwear is essential, with cushion pads over callosities.
Pare with a sterile sharp scalpel blade.
Daily applications of 10% salicylic acid (SA) in soft paraffin with regular paring (if severe).
Corn
Hard corns:
Remove source of friction and use wide shoes.
Use corn pads with low-strength SA.
Soften corn with a few daily applications of 15% SA in collodion or commercial ‘corn removers’ (salicylic acid), then pare carefully.
Soft corns (in webbing toes):
Keep dry.
Pare and curette hard core.
Keep webbing apart with wool preparation or cigarette filter tips.
Plantar warts
Pare wart with a 21 g scalpel blade.
Apply Upton’s paste (salicylic acid + trichloracetic acid) to wart each night and cover (after paring) or
Apply salicylic acid 16% + lactic acid 16% in collodion paint daily or
Apply paste of 70% salicylic acid in raw linseed oil after paring. Occlude for 1 wk, review, pare, apply liquid nitrogen, review or
Apply liquid nitrogen. Repeat in 1 wk, then as necessary.
