Corns Flashcards
Define Hypertrophy
Increase and growth of cells
What is a corn?
A small deep concentrated mass of immature ‘cornified’ cells
What is parakeratosis?
keratosis whereby the keratocytes retain the nucleus in the stratum corneum
What are characteristics of Heloma Durum?
- Clinical Abbreviation = HD
- Small well circumcised hypertrophy of the epidermis with parakeratotic core
- Conical or crescent shaped
- Normally occurs on dorsal aspect of IP joints, under metatarsal heads, and apices of digits
- Usually looks yellow/gray
- Callus normally overlies the lesion/core
What is the etiology of Heloma Durum?
- Intermittent compression / Shear
- Extrinsic factors - poor / ill fitting shoes, high level physical activity, toe deformities
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What are characteristics of Heloma Molle
- Clinical Abbreviation = H Molle
- Soft corn
- Located interdigitally, normally between 4th and 5th digits
- Has a macerated, white appearence
- ‘Rubbery texture’
What is the etiology of Heloma Molle?
- Normally intermittent compression, due to:
- Tight footwear
- Digital deformities
- Hyperhidrosis - excessive sweat
What are characteristics of Heloma Millare?
- Clinical Abbreviation = H Mille
- Can occur on weight bearing and non-weight bearing areas
What is the aetiology of H Mille?
- Thought to occur in response to a combination of forces
- Common areas are Calcaneous and 2nd MTPJ
- Usually chronic
- Can present as asymptomatic - sometimes patients do not report pain
- Normally occur at the periphery of weight-bearing areas
What are characteristics of Heloma Vasculare
- Clinical Abbreviation = H Vasc
- Is a corn with intrusion from vascularised dermal tissue. Extravasation can be present
- Common locations:
- Digital apices
- Dorsal IPJ
- Plantar 1st MTPJ
What is the aetiology of H Vasc?
- Normally excessive mechanical stress:
- Excessive intermittent compression
- Deep shear
- Digital deformity
- poor footwear
What are characteristics of Heloma Neurovasculare?
- Clinical Abbreviation = HNV
- Is a Heloma Durum with intrusion of vascularised dermal tissue into the epidermis, with nerve involvement
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What is the aetiology of HNV?
- Chronic mechanical stress - excessive intermittent compression
- toe deformities
What are characteristics of Fibrous Corn?
- Clinical Abbreviation = HFib
- Long standing corn with presence of fibrous tissue in the dermis
- Can perpetuate chronic irritation of tissue
- Can lead to more fibrosis
What is the aetiology of HFib?
- Excessive deep shearing
- Intermittent Compression
What are characteristics of Durlachers Corn?
- HD, typically lateral to the 5th toenail
- Also known as Listers
- often looks like an extension to the nail, patients often present issue as ingrown toenail or fungal infection
What ist the aetiology of Durlachers Corn?
Often deformity, associated with the 5th digit which has rotated and lies underneath the 4th digit
What is the initial step in the management of treating corns?
Establish the cause
- Diagnostic examination
- Full history of the lesion
- Foot shape
- Shoe size and style
- any marks on the shoe?
What different treatment options are there for corns?
- Sharp scalpel debridement / enucleation
- Podospray
- Patient advice
- footwear apprasial
- emolient use
- Caustics - e.g. Salycilic Acid
- Marigold Therapy
- Surgery
- Padding/Strapping
- Silicones/Otoforms to correct deformities
- Orthotics
What is Podospray, how is it used?
- Is is a drill which sprays water out when used, the aim is for the water to reduce friction and therefore reduce pain when the corn is enucleated
