Hole in the Finger

43 y.o. female with a PMH of stroke, internal carotid artery dissection, HLD, and tobacco abuse presents for a lesion on her finger. Lesion 1: the patient reports that she first noticed roughly a week ago that a "hole" was present on her right medial 3rd digit that did not have any drainage, erythema, pain or pruritis. There was also thickening of the skin that formed around this lesion She reports that it is not painful and she had no fever, chills, or surrounding erythema. She reported no injury or bites in this area. No inciting event and no previous lesion like this in the past. Lesion 2: She then developed few days later on her right index finger a similar looking lesion. No fever chills and no chemical substances touching her hands besides a topical salicylic acid from Walgreen's which she started few days ago that did not have any results. She has full sensation of her finger and it does not hurt when it is palpated. She reports that she is a cook and that she does use a knife and there is repetitive motion to this area. No other lesions like this or rashes on her body. No erythema and full range of motion finger. Exam: No tenderness to palpation and no fluid expressed. The lesion was partially debrided and thick keratinized skin was removed and no drainage was appreciated after it was filed down. Is this just a corn from repetitive microtrauma from using a knifes from cooking?

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Yes this is corn developed due to frictional hypertrophic dermititis Knife is culprit Salicylic acid in lotion form like SALACTIN to be applied twice daily after scrubbing with scrubber for 15 to 20 mts Dress with sterile gauze Definitely it will resolve in a month or so Care to be taken for infection and inflammation Antiinflamatory and antibiotics time to time as needed during the course

Thanx dr Kute Ankush
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IT'S A..CASE OF.. ? FRICTION DERMATITIS.. ? CALLOUS..

Tnx Dr Sheetal Jadhav
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* Friction corn turned into callous due to repeated hardness of object and regular and constant contact to object . Protect against exposure to object for a limited period and reduce contact period. Corn cap covered with gloves. Watnil lotion locally bd. Surgical intervention like laser,cryo therapy can also be a option.

Thanks Dr Kute Ankush
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Bidi burns Callosity

It is corn developed due to frictional hyper keratrophic skin condition Definitely pt was in habit of cutting the corn with knife that is why the hole was iatrogenic. To apply ung salicylic acid to keep the area wet Antibiotic to prevent secondary infection

Friction callocity. Check FBG PPBG. Avoid friction. Keratolytics. Surgical intervention may needed... HPE .

Callus formation due to chronic and repetitive friction.topical keratolytic and local dermabrasion will be helpful.

Friction related keratolytic lesion Conservative management

Callous

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