• Painful keratosis in areas of pressure or friction
  • Usually seen over joints or bony deformity
  • Often seen with toe deformities
  • Associated with poorly fitting footwear or inadequate cushioning

Diagnostic tips

  • Patient may describe “burning” or “drawing” sensation
  • Pain on direct pressure
  • May be secondary tissue breakdown and sepsis
  • Often predisposed by arthritic and other bony deformities

Tests and Imaging

  • Xray may identify osteophyte or exostosis
  • Biopsy atypical lesions

Immediate Treatment

  • Footwear advice
  • Debride hyperkeratosis
  • Apply padding to relieve pressure or friction

Possible Referral

  • Podiatry for expert debridement and custom made padding or insole
  • Podiatry for footwear advice or modification
  • Orthopeadic surgeon for osteotomy.