Definition – A small, circumscribed, deep-seated, conic, horny growth or callosity, usually situated about the toes.
Symptoms. This growth differs from a callosity in forming a small rounded tumor instead of diffuse thickening. It occurs almost exclusively upon the toes. When upon the outer surface it is hard, dry and horny and is known as a hard corn. When between the toes the thickened epidermis becomes macerated, forming a white pulpy swelling, called soft corn. These formations may be single or multiple, pea-sized or larger and are apt to be painful from the pressure of the central core upon the sensitive papillae or from weather changes. On the soles of the feet corns may become very painful and interfere with locomotion.
Etiology and Pathology – The cause of Clavus is intermittent or continuous pressure and friction, usually from tight or ill-fitting shoes. Pathologically, closely paced epidermal cells are found arranged in concentric layers. Hypertrophy of the horny layer is constant feature as in callositas.
Treatment has for its object the removal of the cause, and the wearing of properly fitting shoes. MAny corns will disappear spontaneously after this sensible procedure. Removal of the hypertrophic, horny tissue may be accomplished by carefully paring off the horny substance after it has been softened with soap and hot water. A 25 per cent. salicylic acid or 10 per cent. resorcin plaster placed repeatedly over the corn, will often suffice,or the following solution (Hebra) applied twice daily for three or four days may be used:
Rx Ac. salicycli., gr. xv; 1
Ext. cannabis ind., gr. viij; 5
Alcoholis, mxv; 1
Etheris mxl; 2 6
Collodion flexib., mlxxv; 4 5 M.
Soft corns should be well soaked, followed by applications of silver nitrate or acetic acid. During this treatment soft felt or wool should be worn between the toes during the day. Corn plasters with an open center will afford temporary relief from a painful corn as they shift the pressure from the growth. Corns of any variety may be treated with solidified carbon di oxide using a sharply pointed crayon with firm pressure for one minute. Corns should not be treated so as to excite inflammation which is quite a common result of unscientific home treatment. In a few cases indicated remedies are needed; such as Antim crud., Calcarea carb., Nat. mur., and Sulphur.