Article

The importance of the formulation of a plaster containing salicylic acid in treatment of corns

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  • International Hair Research Foundation
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Abstract

103 patients with hard corns in the dorsal surface of their toes were randomly assigned to 1 of 4 groups and were treated with a commercially available corn removal plaster containing salicylic acid. They were asked to apply the plasters according to the manufacturer's instructions, and they regularly attended the clinic where assessments of the status of the corn were made.Each of the products tested were equally effective in the removal of hard corns, with a mean of 81% enucleation over a period of 10 days. The plaster containing the lowest quantity of salicylic acid caused the least side-effects in terms of maceration spread to surrounding tissue.

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... The treatment of plantar hyperkeratoses accounts for 75% of a podiatrist's total workload in daily practice. 6 Several therapeutic options have been proposed for treating them: keratolytics, 12 moisturisers, 13 paddings, 14 orthotics, 15 footwear, 16 surgery, 17 and patient education. 18 However, because of its simplicity, the treatment of choice is usually scalpel debridement of hyperkeratoses. ...
Article
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Background: Plantar hyperkeratotic lesions are one of the most prevalent foot problems among older people. Because of its simplicity, the most common treatment is scalpel debridement. While some studies have analysed its effectiveness in the short term or among other population groups, none has analysed its effects in the medium term. The aim of this study is to assess the effectiveness of plantar hyperkeratosis debridement compared to a control group receiving sham debridement among an older population group. Methods: Two hundred older participants (76.4 ± 4.8 years) were randomly assigned to two groups: scalpel debridement of plantar hyperkeratoses (experimental group) or sham debridement (control group). Plantar hyperkeratotic pain was measured on a visual analogue scale. Results: The results suggest that there were no significant differences between the groups studied just after treatment (p = 0.27), although significant differences between them were found as from 24 h after treatment (p = 0.05) and 2 (p = 0.03), 3 (p = 0.04), 4 (p = 0.04) and 5 days after treatment (p = 0.04). Conclusions: The results of this study suggest that there were significant differences in self-perception of pain levels between the group of older people treated for plantar hyperkeratoses with scalpel debridement and the control group as from 24 h after treatment.
... There were a number of differences in this trial compared to previous studies. This study included corns on all sites of the foot (dorsal and plantar aspects) and used 'usual' scalpel treatment as the comparator, whereas prior research has only included digital corns and either no comparator or a placebo9101117]. This study is also the first to compare the long and short term effectiveness of corn plasters for up to a year. ...
Article
Full-text available
Corns are a common foot problem and surveys have indicated that between 14-48% of people suffer from them. Many of these will seek podiatry treatment, however there is little evidence to indicate which current treatments provide long term resolution. This study compared 'usual' treatment (enucleation with a scalpel) with the application of 40% salicylic acid plasters to corns to investigate which is the most effective in terms of clinical, economic and patient-centred outcomes. A parallel-group randomised controlled trial was carried out in two centres where adults who presented with one or more corns and who met the inclusion criteria were allocated to either 'usual' scalpel debridement or corn plaster treatment. All participants had measurements of corn size, pain using a 100 mm visual analogue scale (VAS) and health-related quality of life (EQ-5D) measures by an independent podiatrist, blind to treatment allocation at baseline, 3, 6, 9 and 12 months. 202 participants were randomised to receive scalpel debridement or corn plaster treatment (101 in each group). At 3 months 34% (32/95) of corns had completely resolved in the corn plaster group compared with 21% (20/94) in the scalpel group (p = 0.044), and 83% (79/95) had reduced in size in the corn plaster group compared with 56% (53/94) in the scalpel group (p < 0.001). At 12 months, time to corn recurrence was longer in the corn plaster group (p < 0.001). Pain from the corns was significantly lower in the corn plaster group at 3 months (p < 0.001) and EQ-5D scores changed (improved), from baseline, by 0.09 (SD +/-0.31) and 0.01 (SD +/-0.25) points in the corn plaster and scalpel groups respectively (p = 0.056). By month 12, EQ-5D scores had changed by 0.12 and -0.05 in the corn plaster and scalpel groups respectively (p = 0.005). The EQ-5D, VAS scores and the four domains of the Foot Disability Scale were similar in both groups at 3 and 12 months. The economic analysis indicated that corn plasters were a cost effective intervention. The use of corn plasters was associated with a higher proportion of resolved corns, a prolonged time to corn recurrence, less pain and reduced corn size over the first 6 months in comparison with 'usual' scalpel treatment and this intervention was cost effective. Used under supervision of a podiatrist on appropriate patients, corn plasters offer an effective alternative to scalpel debridement.
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