Essay on the Treatment and Management of a Patient with Corns

This essay will discuss the different types of corns. This requires looking at the possible causes, treatment and management of a patient with corns. According to SMAE Institute (2012), the different types of corns include Heloma Molle (soft corn), Heloma Durum (hard corn), vascular and neuro-vascular helomata. Hard corns are described by Carlson et al (2004), as thick hardened patches of dead skin and are a result from repeated pressure or friction occurring underneath the foot, on top of the smaller toes, or the outer side of the little toe. Badly fitted shoes may contribute to this as they rub onto the area causing friction.

Hyperkeratosis is described by the SMAE Institute (2012), as the thickening process of the skin, a protective response due to the area becoming over stimulated due to pressure or friction. Hogan (2012), describes soft corns as being softer due to moisture in between the toes and more commonly found in between the fourth and fifth toes. According to Goldman (2011), the soft corn consists of a ring of hardened skin and has no nucleus. Treatment should be carried out by a professional such as a podiatrist or a foot health practitioner and requires the gentle removal of the outer ring using a scalpel.

The application of astringent or powder to close the pores, reduce sweating and an application of Benzoin compound can be used to harden the skin. The patient should be given advice on appropriate footwear and the use of a gel toe separator to avoid the toes from rubbing together. The SMAE Institute (2012) state the hard corn normally occurs on top of the toes and contains a nucleus. Treatment should include disinfecting the foot and the gentle removal of the thickened skin and the nucleus. A padded dressing should be applied to the area to alleviate pressure and the patient should be advised on suitable footwear.

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If there are any mechanical causes these should be identified and corrective orthotic devices should be prescribed. As described by The SMAE Institute (2012), the treatment for vascular and neuro-vascular helomata requires enucleation with a scalpel. If this is not successful then silver nitrate or salicylic acid may be used to soften the area and eradicate the heloma. It may take several attempts to be destroyed. If a corn is left untreated it may become ulcerated and as a result may become infected.

This will need draining if it contains liquid or pus and/or a course of antibiotics from the General Practitioner may be required. To conclude this essay it is important that an initial assessment is carried out by a podiatrist or health foot practitioner to determine the cause of the problem, so that early treatment can be given to prevent further discomfort. Once the initial treatment is given by the practitioner, regular visits should be maintained and home care advice adhered to. This will maintain the feet in a healthy condition.

References

1. The SMAE Institute, (2012), Module 6, The Skin, Available: www.opencollege.podiatry.com. Last accessed 7th January 2013 Carlson J.K, Eisenstat, A.S, Ziporyn D.T (2004).
2. The New Harvard Guide to Women’s Health. USA: President and Fellows of Harvard College. 38. Hogan. (2012).
3.  treatment. Available: Hogan (2012), available from Medscape.com/article/1089807-treatment. Last accessed 7th February 2013. Goldman C. (2011). corns. Available: Goldman C. (2011), available from weblink: www.footpad.co.uk . Last accessed 3rd february 2013

Bibliography

1. Emedicine.medscape.com/article/1089807-treatment, (accessed 30/8/2012)www.webmd.com/...treatments.../calluses-and-corns-treatment-overv...(accessed 30/8/2012) www.feet for life.org, (accessed 31/08/2012)www.epodiatry.com/corns-callus.htlm, (accessed 09/02/2013)

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