Corn is a local thickening of the surface layers of the skin that occurs under the influence of pressure or friction, most often on the hands and feet. There are dry and wet calluses. The latter look like ordinary wounds and require appropriate treatment. Dry calluses are dense, limited areas of dead skin. Regular treatment of dry calluses during a pedicure or manicure and wearing special protective equipment, as a rule, leads to its gradual decrease and disappearance. Only in some cases, surgical treatment of a corn is necessary.
L84 Corns and callosities
Usually dermatology faces the problem of corns with the development of complications in the form of infection or in cases when the patient’s prolonged attempts to get rid of corns did not lead to the desired results. Most calluses go away with regular removal of layers of roughened skin from their surface. This procedure is usually carried out in manicure and pedicure rooms.
With constant friction or pressure on a certain area of the skin, intense necrosis of its surface layers occurs. At the same time, the dead cells of the epidermis do not have time to peel off and remove from the surface of the skin. As a result, the dead epidermis is layered and compacted with the formation of a corn. With increased sweating, sweat softens dead skin and a soft corn is formed. Lymph can accumulate under the layer of thickened epidermis, which leads to the appearance of a water corn.
The formation of calluses on the hands is associated with the constant friction of the skin of the hands on the handle of a tool (hammer, chisel), gardening equipment (hoe, pruner), sports equipment (crossbar, bars, tennis racket) or a musical instrument (violinists, guitarists, etc.). Calluses can occur on the skin of the elbows and knees.
On the feet, a corn most often occurs due to uncomfortable and too narrow shoes. So high-heeled shoes cause compression of the forefoot, too thin sole increases the load on the arch of the foot, and rough inner seams of shoes can cause additional friction. Constant friction of certain areas of the skin of the foot with the formation of calluses may be due to improper gait or sports (runners, skiers). Calluses are often associated with various diseases and deformities of the foot: bursitis or arthritis of the joints of the foot, deforming osteoarthritis, flat feet, hammer-shaped toes, heel spur.
A hard corn is a dense limited thickening of the skin of a yellowish or yellow-gray color slightly rising above the surface of the skin. A hard corn is characterized by low sensitivity and usually does not cause pain by itself. The pain syndrome is caused by pressure on the corn when working with a tool or walking, when squeezed by tight shoes.
The soft corn has the appearance of an open wound and is characterized by pronounced soreness. A water callus or dropsy is a bubble containing serous fluid. When the bladder is opened, a wound is formed, covered from above with the remains of the dead skin of the bladder.
Separately, the core corn is isolated. Most often, such calluses are formed on the skin of the pads in the area of the III and IV interdigital spaces. They can occur on the back of the fingers and occasionally on the sole. A taproot is a dry corn that has a root that goes deep under the skin. There is a hole in the center of the corn, from which his “hat” is visible. Usually, the formation of a core corn occurs at the site of penetration of a small stone or splinter under the skin.
With improper treatment of the corn, its cutting, the formation of cracks on its surface, infection can occur. Microorganisms penetrating into the corn at the same time cause its inflammation, which is manifested by redness, swelling and pronounced soreness of the corn. Without proper treatment, the corn softens and pus begins to stand out when pressed on it. The inflammatory process from the corn can spread to the surrounding tissues with the development of a corn abscess or phlegmon, to the bones of the foot with the appearance of osteomyelitis, to the synovial membranes and joints of the foot.
Diagnosing a corn by its characteristic appearance is not difficult at all. It is necessary to distinguish a corn from a burr, inflammatory changes in the joints of the metatarsal bones, Morton’s disease, genetically caused increased keratinization of the skin. Some warts, especially plantar warts, may resemble a corn in appearance. A distinctive feature is the great sensitivity of the wart and the occurrence of soreness when it is scrolled, while the corn hurts when pressed.
If the patient has consulted a dermatologist, then the doctor must find out what is the reason for the formation of a corn. To do this, he will ask the patient about his work, hobbies, sports and other hobbies, the nature of the shoes he usually wears. When a corn is localized on the foot, the doctor will conduct an examination aimed at identifying deformities and diseases of the foot, if necessary, he will refer the patient to a podologist, rheumatologist or orthopedist. It is important that the patient has such diseases as diabetes mellitus, neuritis, obliterating endarteritis, varicose veins with chronic venous insufficiency. If such diseases are detected in the anamnesis, consultation of an endocrinologist, neurologist, vascular surgeon or phlebologist is required to determine the most appropriate tactics for the treatment of corns, respectively.
As a rule, a corn that is not accompanied by pain syndrome does not require treatment. When pain occurs, it is necessary to eliminate the factor causing it: narrow shoes, friction on the handle of the tool, etc. To soften the friction and pressure on the corn that occur when walking, special protective pads for the corn help. Such a lining can be made independently. A circle with a hole in the center is cut out of a soft and thick enough fabric. The circle is applied so that there is a corn in the central hole. If the calluses are under the toes, use a special metatarsal lining made of felt, rubber or soft plastic. When placing calluses on the fingers, pads are used between the fingers, sleeves and finger covers. The spacers separating the fingers eliminate their friction against each other. Sleeves and covers that are worn on the fingers protect their side surface and tips.
In the case of dry calluses, the treatment of calluses is carried out in beauty salons as a separate procedure or during a pedicure or manicure. For this purpose, special corn softening compounds, salicylic acid, hardware pedicure are used. Soft calluses and open dropsy are necessarily treated with antiseptics with the imposition of a protective bandage, which is fixed with a plaster.
If deformities of the foot are detected, orthopedic treatment is carried out if possible. In the case of concomitant pathology leading to a violation of innervation or blood supply in the area of the corn, treatment should be carried out jointly with the appropriate specialist. If conservative methods of treating corns do not bring results, it is necessary to remove it. Cryodestruction of the corn, its removal by laser, electrocoagulation, removal by radio wave method or surgical excision can be performed.
Preventive measures aimed at preventing the formation of calluses consist in wearing soft, sufficiently loose shoes with good soles; the use of protective gloves when working with tools, knee pads and other protective equipment to places exposed to constant friction. Proper skin care of the hands and feet, regular use of emollient creams, pumice treatment of areas of increased keratinization of the skin also helps to prevent the formation of corns.