The evaluation of three treatments for plantar callus: a three-armed randomised, comparative trial using biophysical outcome measures

• Published in: Current controlled trials in cardiovascular medicine 2016-05, Vol.17 (1), p.251, Article 251
• Main Authors: Hashmi, Farina, Nester, Christopher J, Wright, Ciaran R F, Lam, Sharon
• Format: Article
• Language: English
• Subjects: Administration, Cutaneous; Adult; Aged; Analysis; Callosities; Callosities - diagnosis; Callosities - physiopathology; Callosities - therapy; Care and treatment; Caustics - administration & dosage; Caustics - adverse effects; Debridement; Debridement - adverse effects; Diabetes; Diagnosis; Elasticity; England; Female; Foot diseases; Foot Diseases - diagnosis; Foot Diseases - physiopathology; Foot Diseases - therapy; Humans; Hydration; Hydroxides - administration & dosage; Hydroxides - adverse effects; Male; Middle Aged; Older people; Pain Measurement; Patient Compliance; Patient Satisfaction; Podiatry - methods; Potash; Potassium; Potassium Compounds - administration & dosage; Potassium Compounds - adverse effects; Quality of Life; Risk factors; Skin; Skin - metabolism; Skin - pathology; Skin - physiopathology; Skin Physiological Phenomena; Surveys and Questionnaires; Time Factors; Treatment Outcome; Trichloroacetic Acid - administration & dosage; Trichloroacetic Acid - adverse effects; Water - metabolism; Young Adult
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-016-1377-2

Callus is one of the most common foot skin complaints experienced by people of all ages. These painful and unsightly lesions often result in disability. The 'gold standard' of treatment is scalpel debridement by a trained specialist; however, people also seek over-the-counter remedies. There is a lack of clinical evidence for the efficacy of such products, which makes selection by patients and practitioners difficult. This randomised, three-armed, parallel, comparative trial aimed to test the efficacy of two home treatments for plantar callus using novel, objective outcome measures (skin hydration using the capacitance method; elasticity using negative pressure application; and surface texture using imaging). Additional outcome measures were: size of callus, quality of life (Foot Health Status Questionnaire) and self-reported participant satisfaction and compliance. The results were compared to a podiatry treatment. Participants were randomly allocated to one of three groups: potassium hydroxide (KOH, 40 %); trichloroacetic acid (TCA); and podiatry treatment. Participants were followed for 3 weeks after their initial intervention appointment (days 7, 14 and 21). The primary outcomes were the change from baseline in callus hydration, elasticity, texture, and size at each of the three time points. The secondary outcomes where: change in quality of life 21 days after treatment; resolution of calluses via visual inspection; and participant compliance and perception. Forty-six participants (61 ft) with plantar calluses were recruited. The podiatry treatment showed immediate and significant changes in all objective outcomes, associated foot pain and function (p