Milker's callus

Calluses are a diffuse area of hyperkeratosis occurring as a normal physiological response to chronic, excessive pressure or friction on the skin. They can be distinctive occupational stigmata when they occur on the hands. Herein we report the occurrence of calluses of the thumb in professional milkers as an occupational dermatosis.

Linear lymphatic hypopigmentation after intralesional corticosteroid injection: report of two cases

Perilesional and linear hypopigmentation, extending cephalad along the lymphatics, occurred in one patient following intralesional injection of corticosteroid suspension for treatment of a hypertrophic scar, and in a second patient following sub-lesional injection of a soft toe-web corn. Atrophy did not occur. Repigmentation in both patients was complete without specific treatment. Review of the literature and evaluation of these patients suggest that the linear hypopigmentation in these two cases was caused by lymphogenous uptake of the corticosteroid crystals.

Corn cures can damage your feet: an important lesson for diabetic patients

Seven diabetic patients rapidly developed severe foot ulceration and sepsis after application of corn cures. Four patients needed forefoot surgery. Corn cures should not be used by diabetic patients.

Hereditary callosities with blisters. Report of a family and review

A family with calluses of the soles associated with blistering is described. Electron microscopic study of a bulla showed an intraepidermal blister with cytolysis of keratinocytes and clumping of tonofilaments. Review of the literature and our own experience with keratoderma palmaris et plantaris revealed no similar patients with this combination of findings. The appearance of the soles is similar to pachyonychia congenita, but the lack of nail and mucous membrane changes is not consistent with that disorder. Treatment with isotretinoin caused reduction in the size of the calluses but exacerbated the blistering.

The therapeutic uses of topical vitamin A acid

Topical vitamin A acid (VAA) has various mechanisms of action which may be responsible for its therapeutic success in many different disorders. Although the absorption, metabolism, and excretion of VAA are not completely understood, VAA appears to remain mainly on the skin surface. The question of carcinogenicity is unresolved, and more research is needed to clarify this problem. This article reviews the literature regarding the therapeutic uses of VAA and summarizes various investigators' experiences with VAA.

[Local vitamin A acid therapy in palmar/plantar hyperkeratoses (authors transl)]

Up to date, the treatment of palmar/plantar hyperkeratoses presents a therapeutic problem. The known therapeutic procedures result in short-term improvement only, if any at all. In these investigations involving 68 patients suffering from palmar/plantar hyperkeratoses of different etiology, small doses of vitamin A acid locally applied, produced a striking improvement in hypertrophic lichen planus of palms or soles: the regression was complete and in most cases permanent. The skin texture of patients with genetic keratoses and callosities became normal within a few weeks: but this condition remained free of symptoms only as long as vitamin A acid was used as a maintenance dose once or twice weekly. In hyperkeratotic eczema, pityriasis rubra pilaris, and verrucae plantaris vitamin A acid locally applied was found to be unsuitable for treatment. The possible side effects of this treatment are mentioned. Several possibilities regarding the way of action of vitamin A acid are discussed.

Treatment of corns by injectable silicone

Corns and calluses are the most frequently encountered foot complaints. The choices of care range from self trimming and application of over-the-counter remedies to professional treatment, which may include tendon, skin, and bone surgery. A technique using fluid silicone injected subdermally to cushion corns is described. Twenty-nine patients with 71 digital pressure keratoses were injected between 1965 and 1970. Results of treatment of 77% of the corns were rated good to excellent after an average follow-up period of six years, and no serious reactions have been observed. The procedure offers an effective, nondisabling method of treatment, as opposed to lifelong palliation or surgical intervention.

Topical administration of vitamin A acid (retinoic acid) in palmar keratoses: callosities, hyperkeratotic eczema, hypertrophic lichen planus, pityriasis rubra pilaris

20 patients suffering from different palmar keratoses were selected for a trial with retinoic acid under controlled conditions. The results can be summarised as follows: (1) in callosities the skin texture could be controlled by intermittent topical applications of retinoic acid once or twice weekly; (2) in hyperkeratotic eczema retinoic acid proved too irritant; (3) in hypertrophic lichen planus, retinoic acid was very effective and the improvement mostly permanent, and (4) in pityriasis rubra pilaris topically applied retinoic acid was found to be ineffective but the disease could be controlled when the substance was systemically administered. The side effects of such treatment are mentioned.