Question

On examination of the feet, the nurse practitioner observes a painful thickening of the skin on the boney prominence of the left fifth toe. This lesion is most likely a _________.

1) Corns
2) Calluses
3) Plantar warts
4) Ingrown toenail

Answer 1

A painful thickening of the skin on the bony prominence of the left fifth toe suggests the presence of a corn, which is a specialized form of a callus caused by mechanical abrasions usually due to ill-fitting footwear.

Step-by-step explanation:

The lesion observed on the boney prominence of the left fifth toe with painful thickening of the skin is most likely a corn. Corns are specialized forms of calluses that develop due to abrasions on the skin resulting from an elliptical-type motion. This condition often arises from wearing shoes that don't fit well, causing constant source of abrasion on toes and thus triggering the basal stem cells in the stratum basale to divide more and increase the thickness of the skin as a form of protection.

In contrast, calluses form from continuous pressure and may not be necessarily painful, whereas plantar warts result from a viral infection and grow into the skin. An ingrown toenail, which involves the nail digging into the surrounding skin, does not result in thickening of the skin.