They may interfere with movement and may have painful fissures and become infected, giving rise to abscesses, lymphangitis, gangrene, or erysipelas. Hyperidrosis is often associated with this condition.
Treatment. The permanent cure of callosities depends exclusively upon the removal of their causation. The position of the foot in the shoe may be faulty because of excessively high or low heels, causing callous skin to appear upon the weight-bearing surface. Occupations requiring constant standing, and deformities, also enter as causative factors which must be considered.
The palliative cure rests for its efficacy on the removal of the horny tissue down to, but not into, the papillary layer.
HELOMA
(Corn or Clavus)
Definition. A heavy thickening of the cuticle, usually caused by pressure, and producing pain by its own pressure on the tissues beneath.
Though the term heloma is rarely used outside of text books, there are very few who have not had an unpleasant acquaintance with this cutaneous affection, under the name of “corns.” Heloma is undoubtedly the most frequent of all skin diseases.
Cause. The exciting cause of helomata is intermittent pressure combined with friction; while among the predisposing causes it is only necessary to mention the slavish adherence to fashion which lends all of us to wear stiff leather shoes, the contour of which bears little or no relation to the natural shape of the anterior portion of the foot. The pressure of the ill-fitting boot upon the toes, or, more strictly speaking, the pressure of the toes against the unyielding leather, in walking, soon occasions hypertrophy of the horny layer at the point of irritation, and in time a dense, conical, pea-sized or larger mass is formed. The apex of the cone presses downward on the sensitive papillae and causes the painful sensation which suggests a visit to the chiropodist.
Helomata are named according to characteristics which mark them. When the growth is indurated it is called heloma durum; when soft, heloma molle; when of the millet seed variety, heloma miliare; when blood vessels are numerous, heloma vasculare. Each of these varieties requires a different method of treatment.