Helomata are most frequently found on the outer surface of the little toes, but may occur upon the sole of the foot and even upon the palm, or plantar surface of the foot. Between the toes they often form from pressure of the opposing digits, caused by narrow shoes, and in this location they are softer and usually present a whitish, macerated surface.
The Prophylatic Treatment consists in wearing a broad-toed, though not necessarily a square-toed shoe.
If shoes were made fan-shaped, like the imprint of a bare-foot in the sand, instead of having the greatest width across the ball of the foot, they might look strange at first, but they would be comfortable for all time. Those then who care more for comfort than for style, as most of us falsely profess to do, would have both cornless and comely feet.
The Palliative Treatment of helomata consists of first softening the dense, hard, horny tissue, when it will exfoliate spontaneously, or be readily scraped away. This projecting callous portion of the heloma may be removed by cutting or scraping till, as nearly as may be, the surface is level with the plane of the adjacent skin.
In the soft variety found between the toes, or in the vascular ones, located in the arch on the inner border of the foot, where the skin is thin, no thick covering will be encountered.
A line or groove will be observed marking the circumference of any variety of heloma, and it is in this line that the operative attack must be made.
Helomata of the miliary variety, usually appear on the sole of the foot and are, as a rule, as numerous as they are small. The preferable treatment is to use a sharp, pointed knife in removing each one of the “seeds” separately.
A well pointed, narrow blade introduced here will find a plane of cleavage between the growth and the surrounding tissue, through which it is possible to dissect quite deeply without encountering blood. When the dissection reaches the papillary layer in the skin, as evidenced by the red color, further operative steps should cease.
In the treatment of soft and vascular growths it may frequently be preferable to employ disintegrating solutions from the beginning.
Repetition of the treatment, as described in verruca, every second or third day, will result in the gradual disintegration of the growth to its extreme depth, and prove more satisfactory than the radical operation.