Portfolio Task: Module 6
“Write a properly referenced essay on the treatment and management of a patient with corns.”
A corn is a thickened area of skin that can occur anywhere on the foot due to pressure. This thickening appears as a cone shaped mass pointing down into the skin. Hard corns (heloma durum) tend to be found on the outer surface of the little toe or on the upper surface of the other toes. Soft corns (heloma molle) occur between toes and are kept soft by moisture in this area.
Contrary to popular belief corns are a normal and natural way for the body to protect itself from areas of high pressure and friction. Corns that are not treated will become painful if the pressure that causes them remains. This can be far more problematic if there are underlying conditions such as peripheral arterial disease (PAD) or diabetes because healing can take much longer and ulcers and infections can develop.
Student No.: 12012403
Enucleation (removal in one piece) of the site, which removes keratinised epidermal cells using a scalpel, can be helped by “… the application of 5% potassium hydroxide aqueous solution for its mild keratolytic action a few minutes prior to reduction”. If the corn is not fully removed then ”…the application of 15-30% salicylic acid…” ”…may be used. This keratolytic used at the above concentrations will produce a slow and painless structural alteration of keratinised tissue, softening and macerating it. The action of this medicament is slow and cumulative, and for this reason it should be left in situ for a period of 5-7 days…” “This treatment may need to be repeated two or three times at weekly intervals to facilitate eradication of the nucleus.” (Neal’s, 2010, p401)
“When complete reduction of the corn is achieved then 25% or 50% silver nitrate solution may be applied. This protein precipitant will ‘shrink’ the walls of the cavity, and repeated applications will return the tissue to
References: Frowen, P., O’Donnell, M., Lorimer, D. and Burrow, G. (2010), Neal’s Disorders of the Foot, Edinburgh, Scotland: Elsevier Limited, p399 Frowen, P., O’Donnell, M., Lorimer, D. and Burrow, G. (2010), Neal’s Disorders of the Foot, Edinburgh, Scotland: Elsevier Limited, p401 Bibliography: www.wikipedia.org/wiki/Corn_(medicine) (accessed 18/11/12) www.epodiatry.com/corns-callus.htm (accessed 19/11/12) Page 4