Patient Management -- Heloma Durum Presentation and Management

The patient suffering from heloma durum typically presents with complaints of discomfort from the formation of hardened tissue in localized areas of the foot such as the on the dorsolateral aspect of the fifth toe or the dorsum of the interphalangeal joints of the lesser toes (Dunn, Link, Felson, et al., 2004; Taylor, Lillis, & LeMone, 2008). While the condition is normally benign (Dunn, Link, Felson, et al., 2004; Freeman, 2002), it can also be the source of physical discomfort that causes patients to alter their choice of footwear and activities, and in extreme cases, it can cause changes in their gait which can also precipitate other...

The condition is normally managed through the most conservative means possible (Hamric, Spross, & Hanson, 2009).
Heloma durum is caused by hyperkeratosis, which is an increase in the keratinocyte activity whereby persistent external pressure such as that associated with friction from footwear stimulates the protective formation of thicker skin layers (Dunn, Link, Felson, et al., 2004; Taylor, Lillis, & LeMone, 2008). Therefore, in most cases, management of heloma durum requires little more than changing footwear to eliminate the source or irritation either alone…