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Corns are hyperkeratotic papules of the skin. They are also known as clavi. These lesions can be painful.
They develop due to excess pressure on the bony prominences of the feet and toes.
Factors that contribute to the formation of corns include:
Abnormal foot mechanics
Foot Deformities
High Activity Levels
Peripheral Neuropathy
Corns are often seen in:
Athletes
Elderly Patients
Diabetic Patients
Types of Corns:
Hard Corn (Helloma Durum)- Commonly found over the joints of toes.
Soft Corn (Helloma Molle)- Found in interdigital locations and has a macerated texture.
Periungual Corn- Found near the edge of a nail.
Presentation:
Corns present with a growth on the foot or toes. Pain is associated with walking or wearing shoes.
Direct pressure generally cause pain to the affected area.
After debridement a corn may have a central plug of skin.
Intrinsic causes:
Foot deformities such as a bunion or a hammertoe
Extrinsic causes:
Activity
Poor fitting shoe gear
Work Up:
X-rays of the feet while weight-bearing can help identifying bony prominences.
Pressure studies- Can help locate the exact location of pressure.
After trimming the lesion the examiner can attempt to determine if the lesion is a corn, callus, or wart.
Treatment:
Hard corns- Pare or debulk the lesion utilizing a small blade. Removal of the centralized plug.
This should be performed regularly in high risked patients such as diabetics.
Regular debridement might decrease the risk of ulceration.
Soft corns- Hygiene is important to decrease the chance of infection. The patient should wear a pair of properly fitting shoes.
The use of an antifungal or antibacterial powder may be helpful.
Toe spacers can also be beneficial.
Other treatment:
Keratolytics such as salicylic acid, urea cream, or lactic acid cream may be prescribed by your doctor.
Good fitting shoe that match the length and width of the patient's feet.
The use of a pumice stone for careful debridement.
The use of good foot hygiene.
The use of a silicone sleeve.
Orthotics
Surgical care:
If conservative treatment fails surgery may be indicated to remove bony prominences.
