Toe Corn, as the name suggests, refers to a specific-shaped callus of dead skin occurring on thin skin surfaces like on the dorsal toe surface, and fingers.
The conical core in a corn, which is a thickening of the stratum corneum, is a protective response to the mechanical trauma.
In case there is continuous tissue stimulation emitting the corns even after the corn is removed through surgery, the skin continues to grow as a corn. Plantar corns are more sensitive to direct pressure of the lesion, while a plantar wart is more sensitive on lateral compression of the lesion.7Sharp debridement and a palliative course of treatment for both warts and calluses can define the underlying etiology of the lesion as being either mechanical or viral. Reducing rubbing motion as well as the pressure can prevent from torn corns to form, by way of taking certain precautions, such as wearing well-fitted shoes, or using protective pads or skin dressings.


Over-the-counter products that contain salicylic acid should be avoided because they may damage surrounding normal tissues, especially in neuropathic and immunocompromised patients.4PADDINGTherapeutic padding can alleviate the patient's symptoms by reducing the amount of mechanical irritation to the site of the corn or callus.
For hard corns, foam pads or silicone toe sleeves offer the cushioning and protection needed after adequate debridement of the corn. Silicone sleeves can be especially beneficial because they cushion the foot while slowly releasing mineral oil to soften the keratotic lesion (Figure 6). A crest pad is an easily fabricated, two-inch cotton roll (dental roll) that is placed under the interphalangeal joints of the lesser toes, on the plantar aspect. In a nonreducible hammertoe, the crest pad can cause further discomfort for the patient by accentuating the deformity; these deformities may respond to a gel-filled corn pad placed over the offending interphalangeal joint.


Patients should be advised to wear low-heeled shoes with a soft upper portion and a roomy toebox.1 Patients with hammertoe deformities may need a shoe with an extra depth to accommodate hard corns that often occur on the top of the deformed toe. Patients with soft or hard corns on the fifth toe may benefit from a shoe that has extra width. The goal of surgical correction of a hammertoe deformity, claw toe deformity, or mallet toe deformity is to reestablish a rectus alignment of a toe that is also free of painful lesions.9 Hard corns on the fifth toe and soft interdigital corns can be treated by resection of the prominent condyles or excision arthroplasty of the proximal phalanx of the fifth toe.



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