As podiatrists and high-heel experts, we regularly treat conditions of the foot and ankle that dramatically effect footwear options. Like the princess and the pea theory, this pesky skin condition may be small but is mighty enough that your favourite closed in pumps and V-necks will be pushed to the back of the closet. Often mistaken for a split nail, this skin condition should be treated sooner rather than later.
Image Credit: Podiatry Today
The Durlacher’s or Lister’s corn is found on the 5th toenail and may be present on the medial (inside) or lateral (outside) aspect of the nail. These lesions seem to be more prevalent in women in our clinic however this is most likely due to footwear choices. Men’s shoes tend to place a lot less pressure on the digits! The corn is positioned alongside the nail plate and for that reason the lesion is commonly mistaken for a split nail. Once the hyperkeratosis or hard skin becomes thick enough to cause pressure, the tissues surrounding the lesion can become very inflamed and painful. Additionally the nerve that runs along the dorsal aspect of the toe may also become irritated and neurological symptoms such as burning and stabbing pain may occur. Basically it becomes too painful to put any pressure on it at all. Sandals it is then?
What is the cause?
Although footwear is a contributing factor there is generally an underlying anatomical reason for the development of this lesion. Yes you heard me-your shoes may not be to blame!
- Patients with Lister’s corns commonly have a symphalangism of the middle and distal phalange in the toe. What? Basically the joint between the two bones in the 5th toe are fused or joined. This affects flexibility in the 5th toe which causes increased pressure when weight-bearing and consequently callus and corn formation.
- The toe has a varus alignment. This means that the shape of the little toe is curved inwards which again places increased pressure on the outside aspect of the nail. Ongoing excessive pressure on one spot on the foot generally results in a corn or callus.
How do you treat it?
- Get to your podiatrist! Initial treatment generally involves debridement of the lesion and in some cases an application of a caustic such as silver nitrate, phenol or salicylic acid. This treatment is generally painless so what are you waiting for?
- If your podiatrist suspects there is an underlying fusion of the joints then an x-ray may be ordered. A positive result on x-ray may determine whether a small surgical procedure is indicated.
So if you suspect you have a Lister’s corn, get to your podiatrist for an assessment. It is usually painless and highly informative. After all your shoe collection is calling you!
Have you had your toe fixed? Maybe these Tom Ford 2018’s can be your celebrationry present!
Until next time,
E&E
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