Question

On examination of the feet, the nurse practitioner observes a painless thickening of the skin under the ball of the foot. It is tender to direct pressure. This lesion is most likely a _________.

1) Plantar fasciitis
2) Bunion
3) Corns
4) Calluses

Answer 1

A painless thickening of the skin under the ball of the foot that is tender to direct pressure is most likely a callus, which results from repetitive pressure or abrasion leading to an increase in skin cell division for protection. Hence, option (4) is correct.

Step-by-step explanation:

On examination of the feet with a painless thickening of the skin under the ball of the foot, tender to direct pressure, the lesion observed by the nurse practitioner is most likely a callus. Calluses occur due to the basal stem cells in the stratum basale dividing more often in response to constant pressure or abrasion, thus protecting the skin. They are different from corns, which are a specialized form of callus with an elliptical-type pressure pattern.

Unlike plantar fasciitis, which involves the inflammation of the tissue connecting the heel bone to the toes, or bunions, which are swellings at the base of the big toe, calluses are specifically thickened skin areas resulting from repetitive pressure.