Plantar Callosities, Corns and Plantar Warts
Office ladies used to wear high heel shoes are often disturbed by painful plantar callosities and corns
They are common skin conditions characterized by thickening of the skin in the affected areas. They are resulted from repeated pressure and friction. Plantar callosities refer to the uniform thickening of the skin with a broad base on the sole. Corns are round in shape and look like the eyes of chickens. There can be hard corns and soft corns. Hard corns are hard and are usually located on the dorsal aspect of deformed toes or lateral side of the foot. Soft corns are resulted from excessive sweating and presence of bony prominences between the web spaces of the toes.
Wearing of high-heeled or ill-fitted shoes is one of the important factors. Improper shoe wear concentrates stress on certain areas of the foot and increases the risk of developing foot deformities such as hallux valgus and hammer toes. Activities requiring prolonged walking or running will also increase the risk of formation of plantar callosities and corns.
Most of the corns are painful and make normal walking difficult. Although plantar callosities can be painless, they may cause pain if they are getting thicker and thicker.
However, plantar wart, which is caused by viral infection, may have similar appearance with corns and callosities. They can infect and spread through minute break or lacerations in the skin. Typically, there are tiny dots of blood vessels underneath thickened skin in viral warts.
In general, corns and callosities are treated by non-operative treatment. The predisposing causes are identified and eliminated if possible eg. Avoid wearing high-heeled or ill-fitted shoes. Reducing the thickness of them can provide symptomatic relief. For example, a pumice stone or a file is used to rub on the hard corns or callosities after soaking the skin surfaces in warm water for about 10 minutes. Other means include the use of corn plasters and trimming. Paring of corns and callosities should be done only by skillful personnel as any wound can lead to serious infection especially in those with diabetes. Orthotic splints may also provide symptomatic relief and prevent further deterioration for those corns and callosities related to hammer toes and hallux valgus.
If the symptom does not relieve by non-operative treatment, more detail clinical assessment and further investigation including X-rays, may be necessary for more definitive diagnosis and treatment. Surgery may be indicated to correct bony deformities for permanent relief of the symptom.
Dr. Siu Kwai-ming