Callus
| Callus | |
|---|---|
| Classification and external resources | |
 Examples of callus found on the toe |
|
| ICD-10 | L84. |
| ICD-9 | 700 |
| MeSH | D002145 |
A callus (or callosity) is an especially toughened area of skin which has become relatively thick and hard in response to repeated friction, pressure, or other irritation. Rubbing that is too frequent or forceful will cause blisters rather than allow calluses to form. Since repeated contact is required, calluses are most often found on feet because of frequent walking. Calluses are generally not harmful, but may sometimes lead to other problems, such as skin ulceration or infection.
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Cause
Many people develop calluses on the middle finger of their dominant hand due to writing with a pen or pencil.
Guitarists often develop calluses on their fingertips, due to the frequent friction on the strings. Bowlers will often develop calluses on the thumb as well as their middle and ring fingers, due to the friction caused in releasing the ball. Bicycle riders can also get calluses, especially if they are not wearing gloves. While swinging on the monkey bars in a play ground, children often develop calluses just above the palms of their hands.
Although usually found on the foot (where the most pressure and friction are applied), 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. Too much friction occurring too fast for the skin to develop a protective callus will cause blisters instead.
People who play a woodwind instrument may develop a callus where they rest their thumb. If they frequently move their thumb under the thumb rest, one may form. This can be avoided by putting a pad on the thumb rest(which can be found at any music store).
Players of string instruments will develop calluses on their fingers purposefully with frequent play. The calluses actually help the player, as the thicker skin protects the fingertips and increases the fingers' ease of sliding on the strings-- extended play is often painful before the calluses develop. Violinists may develop calluses on one side of the chin due to pressure exerted by the chin-rest of the instrument when playing. Before this callus develops, players may experience neck pain and blistering of the chin. Drummers can also develop calluses on their feet or hands, generally viewing these as boons. Calluses on the feet are more common in metal drummers, where double bass drumming is used more often. Use of older sticks will also cause callus on the palms and fingers of a drummer. Percussionists beginning to develop a four-mallet technique (such as the Stevens technique or the Burton grip) often develop blisters in the palms of their hands or in between the index and middle fingers if the aggressiveness of their play is too much for the yet-to-callus skin to handle.
Rowers generally develop calluses at the base of the fingers on the palm, or on the fingers themselves. Duct tape or gloves are sometimes employed to alleviate the friction of turning oar handles.
Sailors will also develop calluses on their hands, due to the regularity of hauling on lines.
Chefs or cooks will often develop calluses across the palm and at the base of the index finger. This is caused by the repeated pressure of chopping or slicing with a chef knife. Before this callus, or calluses, develop, those areas of the hand may blister first. The callus eventually protects the skin in those areas and allows a cook to chop or slice harder and faster. It is referred to as a "knife callus" and is often regarded as a mark of an experienced cook.
Weightlifters will often find calluses on the outside of the palm under the fingers due to frequent gripping of the barbell.
Ice hockey players will develop calluses on the side of the palm due to the friction of the laces when tying their skates and across the inside of the palm under the fingers due to gripping the hockey stick.
Rock climbers develop calluses on their fingers as a result of repeated contact with rough rock when climbing. Most climbers consider calluses on the fingers to be advantageous or even necessary for the sport.
Dancers may develop calluses on the ball of the foot and heel due to dancing barefoot (usually in Modern dance and Contemporary dance ) or en pointe. Many build up calluses purposely to lessen the pain of dancing barefoot or en pointe.
Older devout Muslims may have calluses in the middle of their foreheads from years of performing sujud as part of daily prayer.
People with bunions may find painful calluses behind the second or third toe. These are caused by unequal pressure and rubbing on the smaller toes. Such calluses can be very painful and often do not respond to trimming of the callus, soft materials, or orthotic devices. 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 out the shoe to reduce rubbing may reduce the contact and alleviate 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 corns are difficult to treat because the nail is frequently the primary cause.
Sometimes a callus occurs where there is no rubbing or pressure. These hyperkeratoses can 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.
Prevention
Corns and calluses are easier to prevent than to treat. When it is not desirable to form a callus, minimizing rubbing and pressure will prevent callus formation. Footwear should be properly fitted,[1] gloves may be worn, and protective pads, rings or skin dressings may be used. People with poor circulation or sensation should check their skin often for signs of rubbing and irritation so they can minimize any damage.
Treatment
Calluses and corns may go away by themselves eventually, once the irritation is consistently avoided. They may also be dissolved with keratolytic agents containing salicylic acid, sanded down with a pumice stone or filed down with a callus shaver (diabetics beware risk of infection), or pared down by another professional such as a podiatrist or a Foot Health Practitioner.[2]
Before 1937, when commerce in medicinal cannabis was effectively banned by a federal law in the United States, topical corn remedies usually contained tincture of cannabis, whose anti-bacterial properties were an effective agent. In addition, the inclusion of cannabis provided the herbal green appearance expected by consumers of the day.[3]
Corns
A corn (or clavus, plural clavi) is a specially-shaped callus of dead skin that usually occurs on thin or glabrous (hairless and smooth) skin surfaces, especially on the dorsal surface of toes or fingers. They can sometimes occur on the thicker palmar or plantar skin surfaces. Corns form when the pressure point against the skin traces an elliptical or semi-elliptical path during the rubbing motion, the center of which is at the point of pressure, gradually widening. If there is constant stimulation of the tissue producing the corns, even after the corn is surgically removed, the skin may continue to grow as a corn.
The hard part at the center of the corn resembles a barley hare, that is, a funnel with a broad raised top and a pointed bottom. Because of their shape, corns intensify the pressure at the tip and can cause deep tissue damage and ulceration. Hard corns are especially problematic for people with insensitive skin due to diabetes, etc. The scientific name for a corn is heloma (plural helomata). A hard corn is called a heloma durum, while a soft corn is called a heloma molle.
The location of soft corns tends to differ from that of hard corns. Hard corns occur on dry, flat surfaces of skin. Soft corns (frequently found between adjacent toes) stay moist, keeping the surrounding skin soft. The corn's center is not soft, however, but indurated.
Diabetes
People with diabetes face special skin challenges. Because diabetes affects the capillaries, the small blood vessels which feed the skin, thickening of the skin with callus increases the difficulty of supplying nutrients to the skin. Callus formation is seen in high numbers of patients with diabetes and together with absent foot pulses and formation of hammer toe,[4][5] this may be an early signs of individuals at an increased risk for foot ulcers.[4]
The stiffness of a callus or corn, coupled with the shear and pressure that caused it, may tear the capillaries or adjoining tissue, causing bleeding within the callus or corn. Often, bleeding within a callus is an early sign of diabetes, even before elevated blood sugars may be noticed. Although the bleeding can be small, sometimes small pools of blood or hematoma are 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, infection may follow. Infection may also 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.
Other meanings
In botany, the term is also used to describe a condition of thickened surfaces of leaves or other plant parts. A callus also can refer to an undifferentiated plant cell mass grown on a culture medium, which can be put into a bioreactor to produce genetically identical cells.
See also
- Hyperkeratosis
- Callosity
- Catagmatic
- Zebibah
- List of cutaneous conditions
Notes
- Taber's Cyclopedic Medical Dictionary, 15th Edition, CL Thomas, M.D., M.P.H., editor, F.A. Davis Company, Philadelphia, PA, 1985.
- The Merck Manual of Medical Information, Home Edition, R Berkow, M.D., et al., editors, Merck Research Laboratories, Whitehouse Station, NJ, 1997.
References
- ↑ Erstad, Shannon (6 March 2008). "Foot problems: Finding the right shoes". WebMD Medical Reference from Healthwise. Healthwise. "How do I find the right shoes?". http://www.webmd.com/a-to-z-guides/finding-the-right-footwear-for-your-foot-problem. Retrieved 2010-06-10. "You should not have to "break in" shoes if they fit properly."
- ↑ Corns and calluses: Treatments and drugs. Mayo Clinic. Retrieved July 23, 2009.
- ↑ http://antiquecannabisbook.com/chap6/CornMed.htm
- ↑ 4.0 4.1 Alavi A, Sanjari M, Haghdoost A, Sibbald RG (April 2009). "Common foot examination features of 247 Iranian patients with diabetes". Int Wound J 6 (2): 117–22. doi:10.1111/j.1742-481X.2009.00583.x. PMID 19432661. -12% having callus formation
- ↑ Tantisiriwat N, Janchai S (July 2008). "Common foot problems in diabetic foot clinic". J Med Assoc Thai 91 (7): 1097–101. PMID 18839852. -56% having callus present
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