Black And Blue Corns and Calluses and Diabetes

Black and blue calluses are a bad sign in a diabetic foot, and deserve some attention today in our weekly discussion.

When a callus or corn turns black and blue, or otherwise dark color, either partially in patches or completely under the callus tissue, a dangerous situation has occurred that needs relatively prompt attention.  Corns and calluses are the body's response to pressure, and usually develop where there is a prominent bone that pushes under the skin as the skin is pushed externally by the ground, or by a shoe when on the tops of the toes.  This pressure causes a reaction to form in which the skin's outer compressed cell layer thickens to form a sort of armor to protect the pressurized area.  However, the body does not have a cut-off mechanism to keep the thickening from becoming excessive.  As the corn or callus thickens, it becomes painful in most individuals and they subsequently change the way they walk or stand to reduce this pressure.  Diabetics who have neuropathy (the vast majority of diabetics in all practical sense) do not feel this pain, and the pressure continues unabated until the skin under the corn or callus eventually dies.  Bleeding from burst blood vessels begins, forming the bruising and color under the callus.  The skin tissue itself begins to ulcerate, and a wound is formed.  Because this is not seen externally given the cover of the callus/corn tissue, it can deepen and then fester, leading to a hidden abscess and infection.  The only external sign if often just the callus bruising.

It is therefore very important to have black and blue calluses evaluated by a podiatrist.  While many cases are simply 'preulcerative', meaning that they do not quite have a wound underneath but are about to develop one, there are still many cases that have fully developed a wound that can easily become infected and lead to amputation of not treated early enough.  These calluses and corns need to be reduced, and protective measures need to be taken to decrease the chronic pressure on the skin.  This can be accomplished externally through inserts and padding, or internally with surgery to reduce the bone prominence/deformity.

Until next time,
Scott R. Kilberg DPM

www.inpodiatrygroup.com - foot surgeon, podiatrist in Indianapolis
myachingfoot.blogspot.com -  foot pain explained
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A foot doctor in Indianapolis Noblesville Fishers Carmel Westfield and Fortville Indiana.