The callus and corn conundrum
By Richard P. Holm MD
It is a challenging conundrum or problem that most of us foolishly ignore our feet until they give us trouble.
This last week a woman in her 90s hobbled into my office complaining of an exceedingly sore foot. There was a hard pointed callus on the sole of the foot, where the fat-pad had thinned with age and the bone was very prominent. This had progressed to the point where the pain was keeping her from being able to do activities of daily living, and a blood blister was starting to form under the callus. It was like walking with a large and sharp pebble in her shoe.
I have seen similar foot calluses form a blood blister, get infected, and eventually result in foot amputation. After positioning her on the examining table, with a very sharp scalpel, I gently and carefully shaved layer after layer of thickened skin until the callus was gone. That accomplished, we provided for a molded foot insert that took the pressure off the boney prominence, in order to help prevent recurrence of the callus. She left the office happy with the pebble gone.
Apparently by definition there is a difference between a callus and a corn. Calluses are the natural and protective thickening of skin on the palms of the hand, the soles of the feet, the knees, or anywhere there is prolonged and increased pressure or friction. Corns are by definition smaller, form on the top or side of a toe, have a hard center, and are surrounded by inflammation. And for what it’s worth, it is rumored that the corn was named after the famous ancient Roman scientist and medical writer Aulus Cornelius Celsus.
Most of the time calluses and corns can be prevented by wearing properly fitted shoes and grinding down excessive build-up of skin with sand paper, with pumice stone, or even with fingernails during bath or shower. Commonly this challenging problem occurs because many feet and toes are quite deformed and cannot fit into shoes without resulting in calluses or corns. Sometimes the only solution for such misshapen and distorted feet is surgical correction.
Corns and calluses seem like uninteresting and insignificant medical trivia until pain begins or amputation threatens. Don’t ignore your feet.
Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call®,” a weekly program where medical professionals discuss health concerns for the general public. “On Call®” is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. “On Call®” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at OnCallTelevision.com.