The aetiology and management of plantar callus formation

Booth, J.; Mclnnes, A

doi:10.12968/jowc.1997.6.9.427

Cited by 23 publications

(12 citation statements)

References 9 publications

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“…Therefore, appropriate management of painful corns and calluses in older people is important for maintaining functional status. Scalpel debridement is often the first treatment used for providing temporary pain relief of symptomatic calluses [16-18]. …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial

Landorf

Morrow

Spink

et al. 2013

Trials

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BackgroundPlantar calluses are a common cause of foot pain, which can have a detrimental impact on the mobility and independence of older people. Scalpel debridement is often the first treatment used for this condition. Our aim was to evaluate the effectiveness of scalpel debridement of painful plantar calluses in older people.MethodsThis study was a parallel-group, participant- and assessor-blinded randomized trial. Eighty participants aged 65 years and older with painful forefoot plantar calluses were recruited. Participants were randomly allocated to one of two groups: either real or sham scalpel debridement. Participants were followed for six weeks after their initial intervention appointment. The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention.ResultsBoth the real debridement and sham debridement groups experienced a reduction in pain when compared with baseline. Small, systematic between-group differences in pain scores were found at each time point (between 2 and 7 mm favoring real scalpel debridement); however, none of these were statistically significant and none reached a level that could be considered clinically worthwhile. Scalpel debridement caused no adverse events.ConclusionsThe benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement. When used alone, scalpel debridement has a limited effect in the short term, although it is relatively inexpensive and causes few complications. However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions.Trial registrationAustralian Clinical Trials Registry (ACTRN012606000176561).

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Section: Introductionmentioning

confidence: 99%

Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial

Landorf

Morrow

Spink

et al. 2013

Trials

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“…This natural process of symptom-free hyperkeratosis ( physiological hyperkeratosis ) helps to protect the skin and soft tissue layers from mechanical injury. Hyperkeratosis, however, becomes pathological when the keratinised material builds up sufficiently to cause tissue damage and pain, possibly through the release of inflammatory mediators [ 10 ] or due to the pressure of the central keratin plug on underlying nerves [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Distribution and correlates of plantar hyperkeratotic lesions in older people

Spink

Menz

Lord

2009

Journal of Foot and Ankle Research

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Background: Plantar hyperkeratotic lesions are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people.

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“…Foot callus is a hyperkeratotic skin lesion that commonly develops on the plantar surface of the forefoot in response to compression, friction and shearing forces [ 1 – 3 ]. Being the most common foot skin complaint in people of all ages, many seek advice and treatment from podiatrists [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the ‘gold standard’ of treatment for calluses is scalpel debridement [ 1 , 2 , 9 ] with the regular application of topical keratolytics. Physical removal of callus has been shown to improve quality of life (QoL) and pain outcomes [ 13 ] although it is not clear whether this is the case for older people [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The evaluation of three treatments for plantar callus: a three-armed randomised, comparative trial using biophysical outcome measures

Hashmi

Nester

Wright

et al. 2016

Trials

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BackgroundCallus is one of the most common foot skin complaints experienced by people of all ages. These painful and unsightly lesions often result in disability. The ‘gold standard’ of treatment is scalpel debridement by a trained specialist; however, people also seek over-the-counter remedies. There is a lack of clinical evidence for the efficacy of such products, which makes selection by patients and practitioners difficult.MethodsThis randomised, three-armed, parallel, comparative trial aimed to test the efficacy of two home treatments for plantar callus using novel, objective outcome measures (skin hydration using the capacitance method; elasticity using negative pressure application; and surface texture using imaging). Additional outcome measures were: size of callus, quality of life (Foot Health Status Questionnaire) and self-reported participant satisfaction and compliance. The results were compared to a podiatry treatment. Participants were randomly allocated to one of three groups: potassium hydroxide (KOH, 40 %); trichloroacetic acid (TCA); and podiatry treatment. Participants were followed for 3 weeks after their initial intervention appointment (days 7, 14 and 21). The primary outcomes were the change from baseline in callus hydration, elasticity, texture, and size at each of the three time points. The secondary outcomes where: change in quality of life 21 days after treatment; resolution of calluses via visual inspection; and participant compliance and perception.ResultsForty-six participants (61 ft) with plantar calluses were recruited. The podiatry treatment showed immediate and significant changes in all objective outcomes, associated foot pain and function (p <0.01). Lesser changes in skin quality and perceived pain and functional benefits occurred with TCA and KOH over 21 days.ConclusionsThis is the first study where objective outcome measures have been used to measure changes in the nature of skin in response to callus treatments. We found significant differences in plantar callus in response to podiatry and two home treatments. The podiatry treatment showed immediate and significant changes in skin and associated foot pain and function. Lesser, but sometimes comparable, changes in skin and perceived pain and functional benefits occurred with TCA and KOH over 21 days.Trial registrationISRCTN14751843: date of registration: 30 April 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1377-2) contains supplementary material, which is available to authorized users.

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The aetiology and management of plantar callus formation

Abstract: This update reviews the assessment and management of patients with callus.

Cited by 23 publications

References 9 publications

Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial

Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial

Distribution and correlates of plantar hyperkeratotic lesions in older people

The evaluation of three treatments for plantar callus: a three-armed randomised, comparative trial using biophysical outcome measures

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