Author: Foot Doc
Date: 10/28/2007 6:16 am PDT
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***********************************************************In my opinion, you are not receiving a totally accurate description of your situation from your podiatrist, although, certainly, some doctors choose to be a bit foot-loose and fancy-free with the facts in order that the patient get some sense of what is going on in term to which they might relate.
First of all, a wart is a wart and a callous is a callous. A wart is a living, virally caused tumor which is limited to the upper layers of the skin, and a callous is a layer of dead and keratosed epidermal tissue. There are occasions when a wart can develop a calloused surface, but if the lesion were removed, as you have stated, certainly if it were done in a hospital, there would have been a pathology report which would have identified the tissue. So, in terms of exactly what the tissue removed was, one need only review the pathology report.
But the description which you have offered sounds more in line with either a callous with an especially compact center (sometimes inaccurately referred to as a nucleaus), or what is generally generically referred to as a "porokeratosis," which is technically a keratosed sweat gland, but in most cases, that precise pathology cannot be confirmed. Lesions of the lateral general sort can be otherwise resultant from invagination of epidermis, as when a puncture wound takes place, but many occur for completely unknown reasons.
As far the callous being "embedded," lesions such as those describe above occur within the epidermal areas of the skin only, but the epidermal layer on the plantar of the heel is the thickest of anywhere in the entire body . . thus making the callous seem and actually be deep.
Assuming that either the lesion is NOT a wart, and that if there ever were a wart there, that the surgery may have resulted in scar tissue which now presents itself as the callous, the prospect of total resolution by anything other than a full-thickness excision (which itself may result in father scar tissue) is not terribly likely.
So, again, if my assumptions are correct about the nature of the lesion (and I can give no assurances that they are, as I have not examined you), I would still think that periodic reduction and padding to off-load some of the pressure might be the best course, though it would not likely result in a cure.
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