OSCE Corn and Callus

Question 1

What are Corns/Callus

Answer 1

Callus:
* is a yellowish plaque of hard skin caused by mechanical stress which causes hyperkeratosis or a thickening of the stratum corneum
* Most commonly seen on the plantar aspect of the foot and areas exposed to stress

Corn:
* Is an inverted cone of hyperkeratinised tissue that pushes back into the skin
* also caused by mechanical stress e.g shear friction pressure torsion.
* Both are affectivley an increased rate of keratinisation and a decreased rate of desqumation

Question 2

What are the different types of corns

Answer 2

Helloma durum (hard corn):
* commonly over boney prominences
* dark yellowish
* mistaken for verrucae or foreign body

Helloma Millarie (Seed Corn):
* Single clusters of small corns
* Found on weight bearing areas

Helloma Molle (Soft Corn)
* Interdigital
* white soggy mass

Vascular Corn
* painful upon direct pressure most namely torsion
vascular elements intertwined in the tissue

Question 3

What are the management/treatment options for corns/callus

Answer 3

So provide symptomatic relief either through Enucleation of the corn or removal of the callus through sharps debridement

re- distribute pressure using padding or some form of orthotic device

Address any biomechanical issues which may be causing un neccesary mechanical stress so does the pateint have any toe or foot deformities causing excessive pressure

Address any issues regarding the patients footwear advise patient to wear a low heeled shoe with roomy toebox

Topical solutions to reduce hardness or bulk

Question 4

Contributing factors

Answer 4

occlusive footwear
biomechanical issues so any toe or foot deformities causing excessive pressure
loss of fibro fatty padding over boney prominences (rheumatoid arthrits patients)