Calluses and Corns

Symptoms and Signs

Calluses and corns are caused by intermittent pressure or friction, usually over a bony prominence (eg, calcaneus, metatarsal heads).

Corns consist of a sharply circumscribed keratinous plug, pea-sized or slightly larger, which extends through most of the underlying dermis. An underlying adventitial bursitis may develop. Hard corns occur over prominent bony protuberances, especially on the toes and plantar surface. Soft corns occur between the toes. Most corns result from poorly fitting footwear, but small seed-sized corns on non–weight-bearing aspects of the soles and palms may represent inherited keratosis punctata.

Calluses lack a central plug and have a more even appearance. They usually occur on the hands or feet but may occur elsewhere, especially in a person whose occupation entails repeated trauma to a particular area (eg, the mandible and clavicle of a violinist).

Symptoms and Signs

Calluses are usually asymptomatic but, if friction is extreme, may become thick and irritated, causing mild burning discomfort. At times, the discomfort may mimic that of interdigital neuralgia.

Corns may be painful or tender when pressure is applied. A bursa or fluid-filled pocket sometimes forms beneath a corn.

Diagnosis
Clinical evaluation

A corn may be differentiated from a plantar wart or callus by paring away the thickened skin. After paring, a callus shows smooth translucent skin, whereas a wart appears sharply circumscribed, sometimes with soft macerated tissue or with central black dots (bleeding points) representing thrombosed capillaries. A corn, when pared, shows a sharply outlined yellowish to tan translucent core that interrupts the normal architecture of the papillary dermis.

Source:msdmanuals

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