• Corns

    Corns also called Clavi are areas of hard, dead skin called heloma durum or heloma molle. These areas of keratotic tissue build up form from pressure over a bony prominence.  Typically, these lesions are noted on the dorsum (top) of toes, between toes, or at the distal aspect of a digit.   When I describe this condition to a patient I often remind them of the hard callus that once built up on the 3rd finger from writing, of course that was pre computer age.  That build up of hard tissue was formed due to the bone in the finger rubbing against the pencil or pen.  I always recall a huge lesion on my 3rd digit which has been gone for many years now that I write primarily on computers.  Nevertheless, the concept is generally the same as the toe rubbing in a shoe.  Wolff’s Law theorizes that a bone will remodel to accommodate stress or a load, therefore, a toe that is constantly under pressure will eventually have a bony enlargement which we call an exostosis.  This enlargement of bone will concurrently cause a callus to build up over the protuberance and that will cause a painful lesion over time.  Removal of the build up of hard tissue gives temporary relief, but to eliminate the problem permanently a surgical excision of the enlargement of bone is necessary.  Usually, the surgical excision of the exostosis or bone spur can be performed through a small incision requiring only a single stitch for closure.  Naturally, the surgery that would be needed to correct any given problem depends upon the extent of the deformity.