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Callus
Dermatologically, a callus is an especially toughened area of skin, which has become relatively thick and hard (or callous) as a response to repeated contact or pressure. Since repeated contact is required, calluses are most often found on hands or feet. Calluses are generally not harmful, but may sometimes lead to other problems, such as infection. Shoesthat fit tightly can often form calluses on the feet.
CornsCorns (also called clavi) are specially-shaped calluses that usually occur on thin or glabrous(hairless and smooth) skin surfaces, especially on the top of toes or fingers. They can sometimes occur on the thicker palmaror plantarskin surfaces. Corns form when the pressure point against the skin traces an ellipticalor semi-elliptical path. This forms a swirl of tissue, the center of which is at the point of pressure, gradually widening. If there is constant stimulation of the tissues producing the corns, even after the corn is removed or the pressure surgically removed, the skin may continue to grow as a corn. The name corn comes from its appearance under the microscope. The hard part at the center of the corn resembles a barleyseed, that is, a funnel with a broad raised top and a pointed bottom. "Corn" used to be a generic term for grain, and the name stuck. The scientific name is heloma. Hard corns are called heloma durum, while soft corns are called heloma molle. The place of occurrence differentiates between soft and hard corns. Hard corns occur on dry, flat surfaces of skin. Soft corns (frequently found between two toes) stay moist, keeping the surrounding skin soft. The corn's center is not soft, however. DevelopmentAlthough usually found on the foot(where the most pressure occurs), calluses can occur anywhere on the body as a reaction to moderate, constant "grinding" pressure. It is the natural reaction of the palmar or plantar skin. For example, players of string instrumentswill develop calluses on their fingers with frequent play. This actually helps the player as the thicker skin protects the fingertips - extended play is often painful before the calluses appear. If a beginning player plays too hard, however, a blistermay be produced instead. People with bunionsmay find painful calluses behind the second or third toe. These are caused by unequal pressure placed on the smaller toes. Such pressure-induced calluses can be very painful and often do not respond to trimming of the callus, soft materials, or orthoticdevices. It is not the callus that causes pain, but rather the severe imbalance in the function of the foot that is taking its toll. Shoes can produce corns by rubbing against the top of the toes or foot. Continued irritation may cause pain. Stretching the rubbing area of the shoe may reduce the pressure and stop the pain, but the corn may remain. If a toenail or a fingernail rubs against the skin, pinching it between surfaces for a period of time, a corn can form at the edge of the nail. These are difficult to treat because frequently the nail is the primary cause. Sometimes a callus occurs where there is no rubbing or pressure. These hyperkeratosescan have a variety of causes. Some toxins, such as arsenic, can cause thick palms and soles. Some diseases, such as syphilis, can cause thickening of the palms and soles as well as pinpoint hyperkeratoses. There is a benign condition called keratosis palmaris et plantaris, which produces corns in the creases of the fingers and non-weight-bearing spaces of the feet. Some of this may be caused by actinic keratosis, which occurs due to overexposure to sun, or with age and hormonal shifts. TreatmentA common method, often done by a podiatrist, is to shave the calluses down, and perhaps pad them. For calluses on the feet an inexpensive home remedy is to dissolve a foot soap powder composed of borax, iodine and bran in warm water and soak the feet in the water for 15 to 20 minutes. This softens the calluses so that layers of dead skin can be rubbed away with a cloth towel. Repeated soaking over a period of several days can often allow removal of even the core with nothing more than the friction of the cloth towel. Most corns and calluses located under the foot are caused by the pressure of the foot's bones pressing against the skin, possibly preventing it from moving with the shoe or the ground. While well-fitting shoes will help some of these problems, occasionally some other degree of intervention is required to completely rid the foot of the problem. The most basic treatment is to put a friction-reducing insole or material into the shoe, or against the foot. On some cases, this will reduce the painfulness without actually making the callus go away. In many situations, a change in the function of the foot by use of an orthoticdevice is required. This reduces friction and pressure, allowing the skin to rest and to stop forming protective skin coverings. At other times, surgicalcorrection of the pressure is needed. DiabetesPeople with diabetesface special skin challenges. Because diabetes affects the capillaries, the small vessels which feed the skin its blood supply, thickening of the skin increases the difficulty to supply nutrients to the skin. Additionally, the shearand pressure forces that cause corns and calluses may tear the capillaries, causing bleeding within the callus or corn. Often, bleeding within the calluses is an early sign of diabetes, even before elevated blood sugars. Although the bleeding can be small, sometimes small pools of blood or hematomaare formed. The blood itself is an irritant, a foreign body within the callus that makes the area burn or itch. If the pool of blood is exposed to the outside, infectionmay follow. Infection may lead to ulceration. Luckily, this process can be prevented at several places, but such infections can become life-threatening. Diabetic foot infections are the leading cause of diabetic limb amputation. See also
External links
fr:Cal (médecine) fi:Liikavarvas
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