Corns with black dots on legs and arms

Calluses are a problem known to most people. It is associated with wearing uncomfortable or poor-quality shoes and clothes, with prolonged walking or standing work, with overly sensitive and thin skin - in general, there are a lot of such reasons. As, however, and varieties of corns. Black corn looks especially unaesthetic: it is still often very painful. Therefore, the owners of such a problematic build-up always try to get rid of it if possible. Indeed, the neoplasm should be treated as early as possible. And how to do it right, a medical specialist should tell during an individual consultation.

Causes of the black corn

Black callus often forms on areas of the skin that are subjected to excessive friction or pressure. The appearance of such a growth is a kind of protection of the body, an attempt to resist possible damage to the skin.

In some cases, black callus becomes the result of a pre-existing wet callus, which is a stratification of the epidermis and the accumulation of serous or blood fluid in the resulting cavity. In most people, such neoplasms are found on the palmar part of the hands, soles, heels, outer sides of the legs, which is due to professional characteristics, wearing uncomfortable or low-quality shoes, as well as certain physiological characteristics. In particular, in places of natural skin thinning, black calluses never form: damage to these areas leads to the appearance of wounds or sores, but not growths. [1]

The most common causes of black callus formation are:

• Unsuitable, improperly selected, poor-quality shoes or clothing items. Shoes are the most common provoking factor due to direct, prolonged and intense friction of the skin surface on protruding parts or other defects in shoes. Sometimes the pressure of clothing or its elements is distributed unevenly, unphysiologically, which provokes the appearance of black callus. [2]
• Overweight. Obesity and excess weight contribute to a pronounced increase in pressure on the lower extremities and skin on the foot.
• Congenital and acquired defects, bone deformities. Curvature of the musculoskeletal system causes an incorrect distribution of pressure, leading to zonal thickening and thickening of the skin and the formation of callous growths. Defects can be congenital or acquired as a result of trauma, metabolic disorders, abnormal gait, obesity, use of shoes that do not fit, etc.
• exchange violations. Serious metabolic disorders can directly or indirectly affect trophic processes and the condition of the skin. Many of these diseases disrupt the blood supply to tissues, impair nerve innervation, make the skin more susceptible and sensitive to various mechanical damage. Additional problems arise against the background of a decrease in local immune protection: the risk of infection of abrasions and abrasions increases significantly, which directly affects the formation of black corn.
• Diseases of the nervous system, paresis, paresthesia. With a decrease and loss of skin sensitivity, conditions arise under which black callus is formed. The increased growth of connective tissue is due to weak innervation and incorrect trophic processes.

Risk factors

The prevalence of calluses in the elderly population is estimated to be between 36% and 78%. [3]

The existing factors for the appearance of black corn are conventionally divided into general and local.

The most likely factors include:

• Age. Experts have noticed that patients aged 50-70 are more likely to complain about the formation of black callus. This is due to age-related changes in the skin, dehydration of the epidermis, a decrease in the thickness of the subcutaneous fat layer. In the area of the foot and, in particular, the sole, tissue elasticity deteriorates over the years. The heel becomes rigid, the mechanical properties of the skin change.
• Gender identity. As statistics show, women are more prone to the formation of black callus. The ratio with men is approximately 60:40. Perhaps this is due to different initial elasticity of the skin, differences in the preference for clothes and shoes (in particular, high-heeled shoes often lead to the formation of black corns).
• Excess weight. The incidence of black corn problems increases significantly in people who are obese. This is due to a significant increase in pressure on the lower extremities, with excessive friction of clothing, as well as metabolic disorders and deterioration of the skin in general.
• The degree of physical activity and its features. Black callus is often formed in people who are actively involved in sports, associated with regular stress on the lower limbs and feet. A similar problem is not uncommon among professional runners, cyclists, biathletes, skiers.
• Wrong selection of shoes. The development of black callus is the result of a discrepancy between the shoe model and the shape or size of the foot. At the same time, shoes that are too narrow or too loose can lead to problems. Unfavorable factors are also considered poor-quality synthetic material, broken or damaged insoles, uncomfortable heels, ignoring the wearing of socks, a too hard heel (or its absence, as in slippers), the presence of additional elements on the shoe (buttons, fasteners, belts, lace knots, etc.). ). [4], [5]
• Features of the structure of the foot. In some patients, the feet have some deformities, which during walking leads to changes in kinematics and can cause mechanical overload in certain areas of the lower limb. Especially often the problem occurs in people with equinus and equinovarus deformity, reduced or increased height of the longitudinal arch, valgus curvature of the fingers. Black corns are widespread in patients suffering from rheumatoid arthritis, neuropathy, gout, and diabetes mellitus. [6]
• Body hygiene. If body hygiene and, in particular, hygiene of the lower extremities are not observed, the risk of developing black callus increases significantly, and various infectious complications may also appear. Unfavorable trigger factors are: incorrect temperature conditions (both high and low temperature conditions inside shoes and clothes), increased sweating, lack of socks or their excessive contamination, the presence of dust and dirt directly on the skin.

Pathogenesis

Calluses are formed as a result of hyperproliferation and incomplete differentiation of epidermal keratinocytes, as well as increased expression of adhesion molecules. [7]

Black callus is formed, as a rule, on denser skin integuments, which are able to withstand a sufficiently large load and not be injured. The formation of a build-up occurs:

• with prolonged resistance of the skin area to damaging effects, with the inclusion of compensatory mechanisms, such as compaction, the appearance of connective tissue thickenings, etc.;
• when softening the skin area under the influence of moisture (in wet conditions, the coefficient of friction increases, which ensures the faster formation of black corns);
• with a deterioration in the condition of the skin, which may be associated with a deficiency of vitamins A, E, iron, zinc, as well as severe dietary restrictions or a poor diet.

Black corn does not appear on any part of the body. The palmar surface of the upper extremities or the soles of the feet are most susceptible to the formation of growths. In general, black corns are found in such places:

• the soles of the feet, which are regularly exposed to the load caused by body weight, dynamic pressure during walking, friction on various surfaces;
• interdigital spaces, suffering while wearing narrow models of shoes or with a curvature of the osteoarticular elements;
• palms of the hands interacting with various tools and devices;
• knee zones suffering from prolonged or repeated standing in the knee position;
• elbows, with frequent emphasis on them.

Black callus is closer in formation to hard callus. There is a limited thickening of the skin with a decrease in sensitivity and smoothing of the skin pattern. Finger pressure causes pain due to the impact on the underlying structures (in particular, on the nerve endings). When the keratinized outer layer is removed, a small dark rod or core is found. When the growth is cracked, infection is possible.

Symptoms of the black corn

The first signs of the formation of black callus may appear as periodic itching or tingling in a certain area. Sometimes there is a focus of redness, but pain is not always present (more often, when pressing on the affected area, discomfort is felt).

At an early stage of development, measures are usually taken very rarely to stop the disease process: a person does not think about any treatment, since the emerging seal practically does not bother and does not cause concern. However, the build-up gets worse, darkens, and over time begins to cause more pronounced discomfort, for example:

• black corn becomes inflamed, sometimes it swells;
• pain appears not only with pressure, but also with careful probing of the affected area of \u200b\u200bthe skin;
• discomfort becomes almost constant during walking and movements, which negatively affects both performance and quality of life.

It must be understood that a corn with black dots is not always a corn. Quite often we are talking about a spike, or plantar wart, which occurs under the influence of the human papillomavirus (HPV). Infection occurs when the skin is damaged, and the pathological process itself begins to develop against the background of a weakened immune defense. The main symptoms of thorns: the appearance of an itchy and painful growth, rough in the center, with black dots. The edges are a kind of roller of keratinized skin. The localization of such formations is exclusively palmar and plantar surfaces. The spike grows mostly deep into the tissues, so the black dots present on it are damaged and clogged capillaries that are in the thickness of the wart. Average external dimensions: 3-10 mm.

Black dry corns differ significantly in appearance from normal skin. They have a higher density, slightly rise above the surface. Additional signs, such as soreness, burning, peeling, itching, are not always disturbing.

The situation may change - for example, if a black callus on the toe is damaged, cracked, injured (for example, in vain attempts to remove it on its own). The clinical picture in this case is complemented by reddening of the skin, swelling, the appearance of purulent discharge, local and general fever.

A callus with black roots often forms at the site of excessive pressure or friction. In this case, the "root" is a keratin seal that penetrates deep into the skin, and has a pointed or wedge-shaped rod. Its formation is associated with external influence on a certain point of the body against the background of strong internal resistance of one of the most protruding areas of the bone. The more intense and longer the exposure, the deeper the corn with a black rod will be in the tissues.

A corn with a black dot inside can have a different structure, localization and external signs. Most often, a pathological growth is found in the following areas:

• near the toes;
• in the area of the joints;
• on the heel;
• in the forefoot.

Corn growths, provoked by regular or prolonged friction of clothing items, can be located almost anywhere on the body.

Complications and consequences

Deep penetrating black calluses, if left untreated, can cause complications. The rod, growing deep into the tissues, compresses the nerve roots. Severe pain appears, a person's gait changes, lameness appears, and the ability to work is lost. Against the background of constant pain, insomnia at night and drowsiness during the day begin to disturb, irritability, general weakness, and headache occur.

Under certain conditions, the corn can bleed, suppurate. [8]In such a situation, an appeal to a doctor must be followed: a deterioration in the condition indicates the development of an infectious-inflammatory process. Its symptoms are usually as follows:

• cracks, sores appear in the area of black callus, from which a bloody, cloudy, yellowish or greenish liquid is released;
• the skin around the growth becomes reddish, swollen;
• the pain becomes more pronounced, sometimes throbbing.

You should not try to cure such a pathology on your own: this should be done by a medical specialist.

Diagnostics of the black corn

In most cases, there is no need for a specific diagnosis when black corn is detected. But the doctor should pay attention not only to the growth itself, but also to the reasons that provoked its appearance. So, we can talk about flat feet, arthritis, osteoarthritis, gout, etc. If there are suspicions of a particular disease, then additional diagnostics are really necessary. For example, a doctor may prescribe:

• radiography;
• plantography (obtaining a graphic print of the sole of the foot);
• podometry (calculation of the submetric index);
• general analysis of blood and urine;
• determination of the content of uric acid in the blood;
• computed or magnetic resonance imaging.

In some cases, consultation with other specialists is required - for example, an endocrinologist, surgeon, hematologist.

The actual diagnosis of black callus is usually established after an external examination and assessment of the clinical signs of pathology. Separately, dermatoscopy may be required to determine the type of growth and its differentiation from a wart.

In especially difficult cases - for example, in the presence of atypical symptoms - it is possible to conduct a biopsy, the essence of which is to remove a sample of biomaterial for study. The procedure is performed using local anesthesia: the surgeon cuts off a small piece of tissue (3-7 mm) from the area under study and sends it for examination.

Differential diagnosis

Black corn most often has to be distinguished from a wart. For an ordinary person, this is quite problematic, due to the lack of the necessary experience and knowledge. But the doctor can identify the problem pretty quickly.

Warts with black patches are caused by the human papillomavirus. It is easy to get infected with this virus. At the same time, a person will not even suspect the presence of a viral infection, which can manifest itself only in conditions of a sharp decrease in immunity. This happens during strong hormonal fluctuations, after prolonged antibiotic therapy, severe diseases of an acute and chronic nature.

The most similar to black corns are plantar warts. These are hard seals that have a deep root and create severe discomfort when walking and moving. [9]

In most cases, black callus appears on the skin in an area of prolonged friction or pressure. To distinguish a corn growth from a wart, it is better to consult a doctor.

Other pathologies requiring distinction from black callus:

• Epidermal warty nevus is a neoplasm that rises above the skin surface. Sometimes covered with hair.
• Basalioma is a tumor formation in the form of a nodular ball, covered with a crust in the center. It is more often found in old age.
• Palmar-plantar syphilis is a painless growth, has a tendency to exfoliate along the periphery. Accompanied by a positive reaction to syphilis.
• Keratoderma - keratinized and inflamed areas of the skin, without black dots on the surface.
• Birthmarks, moles, pigmented nevi.

Treatment of the black corn

Black corn can be both dry (hard), and soft, and pivotal. It is the type of growth that plays a major role in what treatment will be applied. Therefore, it is better to consult a specialist who can correctly determine the type of black corn and prescribe the best treatment procedures.

Dry seals can most often be removed at home. It's easy to do this:

• a limb with black corn is placed in very warm water for about 10 minutes (to soften the growth);
• with the help of a wet pumice stone or a special file, they carefully clean off the coarsened tissue, performing circular movements without strong pressure;
• after the procedure, the skin in the treated area is thoroughly dried with a towel, any anti-corn agent is applied that softens the compacted area (usually it contains salicylic acid, ammonium lactate or urea).

If the tissues of the black callus are very dense, or the build-up is large, and its removal with pumice stone can cause bleeding, then it is better to contact a specialist who will eliminate the problem surgically. The procedure is usually painless, due to the absence of nerve endings in the tissues of the callus.

The soft black callus that develops after the preliminary appearance of a blister with bloody contents may disappear on its own over time: the dead tissue dries up and flakes off, exposing healthy clean skin. You should not try to remove such an outgrowth on your own, as this will slow down the healing process, increase the risk of infection and scarring. If there is severe pain, redness in the area of black callus, then you should definitely visit a doctor.

Sometimes a black callus has a rod, which makes it difficult to remove the neoplasm. In such a situation, only a specialist will help, who will drill the rod using a special apparatus with a thin drill, place a drug inside the canal that prevents the problem from reappearing.

Often, to get rid of the pathological growth, anti-corn patches are used, impregnated with various liquids that help soften the keratinized tissues. You can find a suitable patch in almost any pharmacy. However, it must be remembered that their use is undesirable for people suffering from diabetes mellitus and vascular diseases, as well as for those who have too sensitive skin prone to irritation.

In addition to patches, pharmacies offer ointments and creams containing keratolytics in their composition - substances that exfoliate dead cells from the surface of the skin. These external products are only suitable for use by adults. Do not use ointments if there are signs of an inflammatory process, as well as with cracks, wounds in the area of black callus.

Medications

The most popular keratolytic agents with a softening anti-corn effect are divided into alkaline and acid (alpha hydroxy acid) preparations.

Alkaline agents contribute to the dissolution of keratin fibers, as a result of which the tissue softens, which greatly facilitates its further mechanical removal.

Acidic products are not able to dissolve the keratin mass, but successfully destroy the connection of skin scales. Such preparations effectively moisturize, and the effect of one application lasts for several days.

The most common keratolytics include salicylic and lactic acids, barium and strontium sulfides, benzoic and boric acids, resorcinol, glycyrrhizic and citric acids, etc.

• Salicylic acid has a pronounced keratolytic and antiseptic ability, is an active component of many anti-corn agents that are successfully used in dermatological practice. The action of the agent consists of neutralizing the intercellular “connector” that binds epithelial scales, as well as neutralizing the microbial flora.
• Lactic acid is a product of energy metabolism that occurs within tissues during glycolysis. External use of the product allows you to supplement and potentiate the activity of salicylic acid.
• Alpha hydroxy acids, or fruit acids, are able to separate necrotic layers, accelerating skin renewal, increasing the number of healthy cellular structures. In addition, fruit acids perfectly moisturize, delivering moisture even to the deep layers of the skin.

This list of keratolytic agents includes several more drugs, the effect of which has not yet been fully studied, although experts say that they are completely safe for health. Among these substances are urea, perhydrol, sulfur, benzoyl peroxide, thioglycolic acid.

In particular, the most common urea in dermatological practice is characterized by a rather intense keratolytic and moisturizing activity. It promotes the dissolution and softening of keratin fibers, however, for this action a certain concentration of the substance is required: in ointments it is usually 20-30%. In a pure 100% form, urea does not have such a keratolytic property.

Medications to eliminate black corns are available in the form of liquid solutions, ointments, gels. The most famous are the following remedies that are prescribed by a doctor to patients with corns:

• Diprosalik is an ointment with keratolytic and anti-inflammatory properties, which is due to the action of its constituent components: salicylic acid and betamethasone dipropionate. The ointment softens the skin, facilitates exfoliation, relieves swelling. It can be used both for black corns and for psoriasis and eczema. Application features: apply twice a day to the affected area of the skin, rubbing lightly, until the desired result is achieved.
• Synthomycin ointment 10% contains chloramphenicol, castor oil, sorbic acid. Suitable for the treatment of damaged, infected black corns. It is not a keratolytic, but it has a pronounced antibacterial and healing activity. Apply the ointment externally, daily or every other day, for 3-5 days. Longer use is undesirable as it may cause contact sensitization.
• Dr. Foot is a special paste for softening roughened dermis, facilitating the removal of dead tissue. The composition of the drug is represented by urea, allantoin, celandine and D-panthenol. Feature of the product: eliminates even chronic dry black corns. Application: apply the paste on the corn area, stick a patch on top and keep it for 8-10 hours (no more than 12 hours). Next, the patch is removed, the skin is steamed with a hot bath and the corn is removed using a pumice stone or brush. If necessary, after a while the procedure can be repeated. Contraindications: individual hypersensitivity to the components.
• Corn plaster Urgo Koritsid (Urgokor) - contains salicylic acid and a number of auxiliary components. Effectively removes dry and hard black corns and calluses in adult patients. After a hot bath, the skin in the area of application is dried and a patch is glued so that the salicylic paste gets directly to the corn area. Do not allow the active ingredient to come into contact with healthy skin. The patches are changed daily, and the duration of treatment depends on the achievement of the desired effect. Sometimes, after gluing the patch, a short itching may occur, which goes away on its own. Rarely, an allergic reaction is possible.
• Ureotop 12% ointment is an external preparation based on urea, gently exfoliates rough skin, moisturizes and softens well. To achieve the effect, it is enough to apply the ointment 1-2 times a day, intensively rubbing into clean skin. As a rule, the course of treatment is 1-2 weeks. Side effects in the form of redness, tingling, itching are rarely found.

Herbal treatment

Experts say that when black corns appear, patients in most cases are in no hurry to seek medical help, trying to get rid of the problem with their own hands. The first thing people resort to is alternative medicine recipes that have been tested by time and generations. Most often, raw potatoes are used, which are applied overnight under a bandage, lemon peels, fish oil, garlic or onion juice, propolis, and some medicinal plants:

• The milky juice of dandelion relieves dry black corn well, as it softens even very rough skin. You just need to cut the stem and apply the protruding "milk" to the problem area. This should be repeated several times until the result is achieved.
• Pine tree resin is another natural and effective remedy. It is applied to steamed and towel-dried skin, a bandage or gauze is tied over it and warm socks are put on. After 24 hours, the compress is removed, the skin is steamed again and the resin is applied. This is repeated until the corn softens to the desired state, after which it is carefully removed with a pumice stone.
• Aloe leaves are washed, cut lengthwise. The cut side is applied to the black corn, having previously steamed it. Fix with a bandage. The procedure is carried out at night, in the morning the compress is removed. This is repeated until the desired effect is achieved.

Important: if signs of an inflammatory process or other suspicious symptoms appear in the growth area, you should definitely consult a doctor.

Surgery

At the initial stage of the formation of black corn, conservative methods of treatment are successfully used, including the correct selection of shoes and clothing, the use of special liners, bandages and insoles, etc. It is appropriate to use medications that soften the corn growth - in particular, keratolytic ointments and pastes.

If conservative treatment does not lead to a positive result, the growth regularly recurs, or there is a too deep root, then the doctor may recommend surgical removal of the black callus. It is performed mainly by one of the following methods:

• Standard excision of the corn tissue with a scalpel or treatment with a perforated incision,  [10] enucleation. [11]The procedure is quite traumatic, but sometimes black callus can be removed only in this way. The operation does not require preliminary preparation and placement of the patient in a hospital, is easily tolerated, but has some features of postoperative care, which the doctor will tell you about. [12]
• cryodestruction method. The method of freezing with liquid nitrogen, known to many, is quite effective: frozen tissues are torn off within a few days after the procedure, exposing healthy skin.
• laser removal method. If compared with cryodestruction, then laser removal does not involve freezing, but, on the contrary, high-temperature exposure. As a result of the procedure, keratinized structures heat up and evaporate. Healthy skin does not suffer. This technique is considered the most optimal.
• radio wave method. Black corn is removed by exposure to radio wave energy.

If during the consultation the doctor discovers that the black callus has become complicated by an infectious and inflammatory process, then the surgical intervention is postponed. Appropriate therapeutic measures are prescribed to eliminate inflammation and neutralize the infectious agent. Therapy may include the use of anti-inflammatory drugs and antibiotics. After completing a conservative treatment course, the doctor again considers the possibility of surgical removal of black callus.

Prevention

Preventive rules to prevent the formation of black callus are quite simple. They must be remembered and observed in order to avoid the occurrence of such problems.

• Both clothes and shoes should be comfortable, of high quality, appropriate in size and fullness.
• Too high a heel on shoes is undesirable. If you still have to wear "high" shoes, then you should put in them special anti-slip insoles or silicone inserts, which are usually sold in shoe stores, pharmacies or online stores.
• Wear suitable protective gloves and safety shoes when doing sports or gardening.
• It is important to carefully follow sanitary and hygienic recommendations, take a shower daily, use moisturizing products (both for hands and feet), change underwear and socks in a timely manner.
• If there are problems with the joints (including those on the fingers), you should consult a doctor without waiting for their aggravation. The specialist will help to correct the position of the foot, prescribe treatment, select the optimal orthopedic insoles or shoes to prevent the appearance of black corns.
• It is necessary to maintain the nails in adequate condition, to prevent excessive growth of the nail plates and their ingrowth. If possible, it is recommended to regularly perform pedicure procedures, remove rough skin.

For preventive purposes and at an early stage of black corn formation, it is recommended to use:

• protective patches that prevent the appearance of growths in places of regular friction of the skin;
• special cosmetics that provide care for rough skin;
• special anti-slip shoe inserts and insoles;
• insoles, bandages, retaining liners, correctors for toe and foot deformities (should be selected by an orthopedic specialist).

If an outgrowth in the form of a black callus nevertheless appeared, then the best solution would be to seek the help of specialists: orthopedists, podologists, dermatologists. Medical consultation will help to make the correct diagnosis, determine the treatment. This is important, first of all, because therapeutic measures for black corn and warts are very different. In order not to harm your health and quickly get rid of the problem, you need to consult a doctor.

Forecast

In most cases, black callus does not cause complications and has a favorable prognosis if the disorder is not neglected. However, cases are not excluded when, in the absence of therapeutic measures, the growth increases, pain appears, and working capacity is limited. There is also the possibility of tissue infection: when an infection enters, an inflammatory reaction is triggered. The black callus swells, the pain intensifies, there is a danger of suppuration.

For patients with diabetes mellitus or those suffering from peripheral circulatory disorders, the prognosis is somewhat less favorable. There is a high risk of complications, and the treatment process can be significantly delayed.

If timely measures are taken and treated by a specialist, then the black corn will disappear quickly enough and without complications.