Corn (medicine)

Painful corns

A corn (or clavus, plural clavi) is a specially shaped callus of dead skin that usually occurs on thin or glabrous (hairless and smooth) skin surfaces, especially on the dorsal surface of toes or fingers. They can sometimes occur on the thicker palmar or plantar skin surfaces. Corns form when the pressure point against the skin traces an elliptical or semi-elliptical path during the rubbing motion, the center of which is at the point of pressure, gradually widening. If there is constant stimulation of the tissue producing the corns, even after the corn is surgically removed, the skin may continue to grow as a corn.^{[citation needed]}

Presentations

The hard part at the center of the corn resembles a barley hare, that is, a funnel with a broad raised top and a pointed bottom. Because of their shape, corns intensify the pressure at the tip and can cause deep tissue damage and ulceration.^[1] Hard corns are especially problematic for people with insensitive skin due to diabetes, etc. The scientific name for a corn is heloma (plural helomata). A hard corn is called a heloma durum, while a soft corn is called a heloma molle.

The location of soft corns tends to differ from that of hard corns. Hard corns occur on dry, flat surfaces of skin. Soft corns (frequently found between adjacent toes) stay moist, keeping the surrounding skin soft. The corn's center is not soft, however, but indurated.

Diagnosis and workup

To exclude other differential diagnoses, a skin biopsy may be taken.^[1] Imaging studies can be used in order to detect any underlying bony abnormalities that cause abnormal pressure on the overlying skin.^[1] For this purpose, a plain radiograph usually suffices, but, occasionally, CT scanning is used.^[1]

Treatment

Treatment of corns include paring of the lesions, which immediately reduces pain.^[1] However, if an abnormal pressure source remains, the corn generally returns. If the source of any abnormal pressure is detected, this may be avoided, such as with orthotics and conservative footwear with extra toe space.^[1] If no other treatment is effective, surgery may be performed.^[1]

References

1. ^ ^{a b c d e f g} eMedicine > Clavus By Nanette Silverberg. Updated: Apr 9, 2010

External links

• eMedicine > Clavus