Terminal learning objective



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Corns and Calluses (see figure 3) – a callus is a thickening of the outer layer of skin, in response to pressure or friction that serves as a protective mechanism to prevent skin breakdown. A corn is similar to a callus except it involves a discrete pressure spot, typically over a bone, whereas a callus can form anywhere.

Causes

-
Figure 3. Corns and Calluses


Tight fitting shoes, due to chronic friction and sheering pressure

- Deformed and crooked toes

- Prolonged walking on a downward slope

Signs and Symptoms

- Thickened, dry skin over prominent bones (corn)

- Large patches of thickened, dry skin over friction areas from walking (calluses)

- Pain on direct pressure against the corn

- Skin breakdown and possible infection with continued irritation

Treatment

- Debridement of excessive buildup of skin

- Apply various pads and devices to the toes to relieve pressure (mole skin, corn pads, etc.)

- Fix the cause (improperly fitted boots)

- In extreme cases, refer to a Medical Officer
Bunions (see figure 4) – a bunion is an enlargement at the 1st metatarsal head of the great toe, which deviates laterally. Often there is no bump, but rather an angulation of the first metatarsal that makes the head of this bone more prominent.

Causes

- A minor bone deformity, called hallux valgus, in which the joint at the base of the big toe projects outward while forcing the tip of the toe to turn inward toward the other toes. As a result of the pressure on the deformity, the surrounding tissue thickens.



- This condition may be hereditary.

- Poorly fitted or excessively worn shoes.



Signs and Symptoms

- Thickened lump on the medial side of the foot at the base of the great toe

- Erythema

- Pain near first metatarsal head

- Joint stiffness

Treatment

-




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