Fortnightly Review: Callosities, corns, and calluses

Summary points

• Corns and calluses arise from hyperkeratosis, a normal physiological response to chronic excessive pressure or friction on the skin

• They may be caused by excessive irritation from poorly fitting shoes or by abnormal pressure if there is a deformity of the foot

• Treatment should therefore not only provide symptomatic relief (such as by regular paring or using keratolytic agents) but should also alleviate the underlying mechanical cause

• Most lesions can be managed conservatively by use of sensible footwear (properly fitting shoes with low heels, soft upper, and roomy toebox) and orthoses to redistribute mechanical forces

• Surgery is rarely indicated and should be specifi- cally aimed at correcting the abnormal mechanical stresses