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Abstract: Corns are skin problems caused by limited keratin thickening on the feet, which often lead to painful walking and affect normal life. The patient had a corns on her foot 2 months ago, and she did not care about it in the early stage because she had no special symptoms, but later the corns grew gradually, so she applied corns ointment externally, but it was not effective and even became infected. After consultation, the patient was given topical medication to disinfect and received cryotherapy after the inflammation subsided. After cryotherapy, the corns fell off and were cured.
Basic information】Male, 65 years old
Disease Type】Cocksore
Hospital】Maanshan Seventeen Metallurgy Hospital
Time】May 2022
Treatment plan】Medication (boric acid lotion + fusidic acid cream) + cryotherapy
Treatment Period】4 weeks of outpatient treatment
Effectiveness】The corns fell off and were cured.
I. Initial consultation
The patient, 65 years old, had a corns on his foot 2 months ago. At first there was no discomfort, no pain and no itch, so he did not care, but later the corns gradually grew and became slightly painful when walking, so he treated himself with corns cream. After 1 week of using the drug, the patient found that the ulcer appeared at the corns and the pain increased, which already affected walking. Fearing that the wound would become infected, he came to our hospital. After examining the corns on the patient’s feet, we found that the corns were located on the lateral side of the left foot, the size of a fava bean, with ulcers and edema on the surface, salicylic acid powder from the corns cream attached to them, and the symptoms of soft tissue infection appeared, and the diagnosis was corns with local infection.
Second, the treatment process
In view of the soft tissue infection of the corns on the patient’s feet, the patient was instructed to stop using corns, and was given topical anti-inflammatory treatment, first with boric acid lotion and then with topical fusidic acid cream. After 1 week of medication, the patient’s corns were reviewed, and the foot infection and pain symptoms were found to be significantly improved, so cryotherapy was prepared.
Cryotherapy involves freezing the corns of the skin with liquid nitrogen at -196°C until they turn white, pausing for 1 minute, then freezing again, and so on for 5 cycles to produce blisters after the corns are edematous, followed by debridement of the blisters. After performing the cryotherapy, the patient was instructed that the trauma would produce blisters or blood blisters, and that when the blisters or blood blisters were large, they would need to come to the hospital to have the blister fluid removed, and that the blister skin should be protected to reduce infection. On the same night, blisters appeared on the corns of the patient’s feet, and the blisters were large in size. On the second day, the patient immediately went to the outpatient clinic and used a syringe to draw off the blisters, and throughout the treatment, the patient had significant pain.
III. Treatment effect
After aspiration of the blisters, the patient was instructed to go home and continue to apply boric acid lotion and topical fusidic acid cream. Three weeks later, the patient came back for a follow-up visit and reported that 3 days after the fluid was removed from the blister, the crust had appeared on the wound, and 2 weeks after the fluid was removed, the crust of the corns had fallen off. Checking the patient’s corns again, palpation revealed that the residual corns tissue could no longer be touched, achieving a clinical cure without the need for a second cryopreservation, for a total of 4 weeks of treatment.
IV. Notes
I was happy for the patient when I saw that he got rid of his corns. However, as corns may recur, patients still need to pay attention to the following points in their daily life.
1, because the recurrence of corns is mostly due to foot extrusion, friction pressure caused, so patients usually wear shoes to choose more loose shoes, pay attention to thick insoles, do not wear leather shoes.
2, if corns reappear, should avoid walking, activities to reduce foot friction, squeezing. For small corns, you can use a file to sterilize and repair, and then apply corns ointment, but when using a file, you must pay attention to sterilize the knife, corns repair should also be disinfected with iodophor to avoid infection, once the re-emergence of large corns, should promptly come to the clinic.
V. Personal insight
Corns are skin problems caused by the thickening of the limited corns on the feet, mostly related to foot extrusion and friction, and often occur in people with ill-fitting shoes and more activities, among which, women who like to wear high-heeled shoes are more likely to occur. Corns are not contagious, but need to be treated in time, otherwise they may grow bigger and bigger and eventually cause tissue infection. The patient in this article is precisely because the corns were not treated in the early stage, and the corns gradually grew and still only used corns cream to apply, thus leading to local tissue infection. This also tells us that when symptoms of discomfort appear in daily life, we should promptly seek medical attention or intervention to avoid further development of the condition and increase the difficulty of treatment.