Fortnightly Review: Callosities, corns, and calluses

Summary points Corns and calluses arise from hyperkeratosis, a normal physiological response to chronic excessive pressure or friction on the skin They may be caused by excessive irritation from poorly fitting shoes or by abnormal pressure if there is a deformity of the foot Treatment should therefore not only provide symptomatic relief (such as by regular paring or using keratolytic agents) but should also alleviate the underlying mechanical cause Most lesions can be managed conservatively by use of sensible footwear (properly fitting shoes with low heels, soft upper, and roomy toebox) and orthoses to redistribute mechanical forces Surgery is rarely indicated and should be specifi- cally aimed at correcting the abnormal mechanical stresses